血CRP和Wnt5a水平的动态变化对脓毒症诊疗的临床意义

Clinical Significance of Changes of Blood PCT and Wnt5a Levels in the Diagnosis and Treatment of Sepsis

目的探讨动态监测血C反应蛋白(C reactire protein,CRP)和Wnt5a水平的相关变化对脓毒症患者诊疗的临床意义。方法选择2010-01/2014-02月作者科室收住的脓毒症患者15例,将15例脓毒症患者随机配对分为常规治疗组,常规治疗+胰岛素组,常规治疗+强化胰岛素组。在入科的第2,4,6,8天检测CRP及Wnt5a水平,同时行血培养,根据血培养结果分为血培养阳性组和血培养阴性组。结果在脓毒症血培养阳性组第2,4,6,8天,Wnt5a水平及第6,8天的CRP水平明显高于血培养阴性组;三组患者中CRP水平与Wnt5a随时间呈下降趋势,在ROC曲线中,Wnt5a有更好的敏感性和特异性。结论脓毒症患者血清Wnt5a水平较CRP水平与脓毒症严重程度有着更明显的相关性,动态监测Wnt5a水平变化有助于脓毒症严重程度的判断及临床治疗。

Objective To observe the changes of CRP and Wnt5a levels in the clinical significance of the diagnosis and treatment of sepsis.Methods Fifty septic patients were collected in our hospital from January 2010 to February 2014,randomly divided into three groups：conventional treatment group,conventional treatment and insulin treatment group and conventional treatment and intensive insulin treatment group.Blood samples for testing CRP and Wnt5a level were taken on the 2,4,6,8 day of hospitalization,and blood culture was collected at the same time.According to blood culture results to divide them into two groups：blood culture positive group and blood culture negative group.Results The Wnt5a levels of 2,4,6,8 days and CRP levels of 6,8 days in the blood culture positive group were significantly higher than those of blood culture negative group.The Wnt5a and CRP levels of the three groups decreased over time,the sensitivity and specificity of Wnt5a were higher than those of the CRP under the area of ROC in the diagnosis.Conclusion The Wnt5a levels in patients with sepsis compared with CRP levels have a more significant correlation with the diagnosis of sepsis and the observation of Wnt5a levels can help in the evaluation and the clinical therapy of sepsis.