PCT、超敏C反应蛋白、乳酸在脓毒血症预后评断中的应用价值

Application Value of PCT,hs-CRP and Lactic Acid in the Sepsis Prognosis Judgment

目的:探讨降钙素原(PCT)、超敏C反应蛋白(hs-CRP)、乳酸检测在脓毒血症诊断与预后中的应用价值。方法:选取2011年1月-2015年10月笔者所在医院确诊为脓毒血症病例70例。根据其严重程度及预后,分为两组,预后良好组,共44例;预后不良组(包括病情明显加重,出现多器官衰竭或者死亡),共26例,监测两组患者治疗前PCT、hs-CRP、乳酸水平,比较两组PCT、hs-CRP、乳酸变化,比较三者在反映病情的严重程度以及判断预后中的关系。结果:两组患者PCT均升高,预后良好组PCT水平较预后不良组偏低,下降较快,预后不良组持续升高;hs-CRP均升高,两组升高比较差异无统计学意义(P>0.05),预后良好组缓慢下降;乳酸在预后良好组水平偏低,而且下降较快,在预后不良组,乳酸水平持续升高。结论:在脓毒血症严重程度判断上,PCT、乳酸优于CRP,PCT、乳酸水平越高,提示脓毒血症病情越重,但两者的下降速度更能反应患者预后。

Objective：To explore the application value of PCT,hs-CRP,Lactic acid in the sepsis prognosis judgment.Method：A total of 70 cases with sepsis were selected from January 2011 to October 2015.Patients were divided into two groups according to prognosis,44 patients with good prognosis were in the first group,another 26 patients with poor prognosis were in the second group.The level of PCT,hs-CRP,lactic acid of two groups before treatment were monitored.PCT,hs-CRP,Lactic acid between two groups were compared after treatment,and the prognosis for sepsis were studied.Result：PCT,lactic acid were elevated between two groups,the level of PCT,lactic acid in the good prognosis group were lower than those in the poor prognosis group,which decreased rapidly,however,they were continued to rise in the poor prognosis group.Hs-CRP were elevated with no obvious difference between two groups,and descented slowly in the good prognosis group.Conclusion：In the diagnostic of sepsis,PCT,lactic acid are superior to hs-CRP.The higher level of PCT and lactic acid,the severer condition in the sepsis,but the decline rate is more reactive with the prognosis of patients.