严重多发伤患者血清降钙素原水平与多器官功能障碍综合征的相关性

Relationship between serum levels of calcitonin and multiple organ dysfunction syndrome in patients with severe multiple trauma

目的探讨严重多发伤患者血清降钙素原(PCT)水平与多器官功能障碍综合征(MODS)发生的相关性。方法选择2013年5月—2015年5月河北省沧州市人民医院重症医学科病房收治的严重多发伤患者66例,依据有无发生MODS将其分为观察组(合并MODS)34例和对照组(无MODS)32例,比较2组血清PCT水平变化情况并分析其与疾病的相关性。结果观察组住院后第1、3、5、7天时的PCT水平随着住院时间逐渐下降(P<0.05),而对照组无明显变化(P>0.05);观察组的PCT水平均显著高于同时间点对照组,比较差异有统计学意义(P<0.05)。观察组在入院时APACHEⅡ和ISS评分均显著高于对照组,差异有统计学意义(P<0.05)。观察组病死率为52.94%(18/34),显著高于对照组的9.38%(3/32),差异有统计学意义(x^2=8.73,P<0.05)。存活病例和死亡病例PCT水平比较差异均有统计学意义[(1.95±0.47)ng/ml vs.(8.53±3.01)ng/ml,t=8.71,P<0.05]。PCT水平与APACHEⅡ评分、ISS评分及MODS呈正相关(r=0.432、0.442、0.634,P<0.05),而与病死率之间无显著相关性(r=0.283,P>0.05)。结论随着多发伤患者病情程度的加重,PCT水平亦呈现增高趋势,故临床中可应用PCT对病情程度及MODS的发生与否进行初步判定。

Objective To investigate the correlation between serum levels of calcitonin（PCT） and multiple organ dysfunction syndrome（MODS） in patients with severe multiple trauma.Methods From May 2013 to May 2015,66 cases of severe multiple trauma patients in the department of ICU,Cangzhou People＇s Hospital were enrolled,according to the MODS,they were divided into the observation group（combined with MODS） in 34 cases and the control group（no MODS） in 32 cases,the change of serum PCT levels were compared between the two groups and analyzed its correlation with disease.Results The 1st,3rd,5th,7th days after hospitalization PCT levels in the observation group were decreased along with hospital stay length（P〈0.05）,while the control group had no significant change（P〉0.05）.The PCT level of the observation group was significantly higher than that of the same time control group,the difference was statistically significant（P〈0.05）.The APACHE Ⅱ and ISS scores in the observation group were significantly higher than those in the control group,the difference was statistically significant（P〈0.05）.In the observation group,the mortality rate was 52.94%（18 / 34）,which was significantly higher than that of the control group,the mortality rate was 9.38%（3 / 32）,and the difference was statistically significant（χ^2= 8.73,P〈0.05）.There were significant differences in the PCT levels of survival and death cases（1.95 ±0.47 ng/ml） vs.（8.53 ±3.01 ng/ml,t =8.71,P〈0.05）.and PCT level was positively correlated with APACHE Ⅱscore,ISS score and MODS（r = 0.432,r = 0.442,r = 0.634,P〈0.05）,but there was no significant correlation with mortality（r =0.283,P〉0.05）.Conclusion With the aggravation of the condition of multiple trauma patients,the level of PCT also showed an increasing trend,so it can be used to determine the severity of the disease and the occurrence of MODS and PCT.