降钙素原和血乳酸对脓毒症合并弥散性血管内凝血的诊断价值

Diagnostic Value of Procalcitonin and Blood Lactate in Patients with Sepsis and DIC

目的:初步分析降钙素原(PCT)和血乳酸(Lac)水平测定对脓毒症患者发生弥散性血管内凝血(DIC)的诊断价值。方法:选取2012-08-01至2015-12-30本院重症监护室(ICU)收治脓毒症患者70例,根据是否合并DIC分为DIC组(n=34)和非DIC组(n=36)。两组患者入ICU 24h内检测PCT和Lac浓度,同时测定血小板计数(PLT)、血浆凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、纤维蛋白原(FIB)、D-二聚体(D-D)水平,并进行急性生理与慢性健康评分(APACHEⅡ),比较上述指标组间差异;建立ROC曲线,计算PCT、Lac曲线下面积(AUC)及其诊断DIC的敏感度和特异度。结果:DIC组PCT和Lac水平明显高于非DIC组(P均<0.01);其它检测指标和APACHEⅡ评分组间差异亦有统计学意义(P<0.01);PCT和Lac的AUC分别为0.871和0.790;PCT和Lac的敏感度分别为91.20%和79.40%。结论:PCT与Lac可作为脓毒症合并DIC早期诊断的敏感指标。

Objective：To analysis the diagnostic value of procalctionin（PCT） and serum lactic acid （Lac） lev‐els in patients with sepsis and disseminated intravascular coagulation （DIC） .Method：A total of 70 cases of 2012‐08‐01 to 2015‐12‐30 patients who came from ICU with sepsis ,according to whether the combination of DIC was divided into DIC group （n=34） and non‐DIC group （n=36） .Two groups of PCT and Lac ,platelet （PLT ） ,prothrombin time （PT） ,activated partial thromboplastin time （APTT ） ,fibrinogen （FIB） ,D‐Dimer （D‐D） level ,and acute physiology and chronic health score （APACHE II）were detected compare the differences between the two groups . The ROC curve was established ,calculate the area under the curve of PCT ,Lac （AUC） and the sensitivity and spe‐cificity of the diagnosis of DIC .Results：The levels of PCT and Lac in DIC group were significantly higher than those in non‐DIC group （P〈0 .01） .There were statistically significant differences between the other test indicators and the APACHE II score （P〈0 .01） .The area under the curve of PCT and Lac was 0 .871 and 0 .790 .The sensi‐tivity of PCT and Lac was 91 .20% and 79 .40% .Conclusion：PCT and Lac can be used as a sensitive indicator for early diagnosis of sepsis associated with DIC .