PCT清除率在脓毒症预后判断中的价值

The value of PCT clearance rate in the prognosis of sepsis

目的通过观察ICU脓毒症患者降钙素原血清浓度及其清除率与预后的关系,评价降钙素原及其清除率在判断脓毒症患者预后中的价值。方法本研究纳入了2012年1月~2014年1月本地综合ICU内的脓毒症患者311例。收集患者的基本情况,一般生命体征及一般实验室检测指标。入组第1d 24 h内抽血血液标本检测PCT的血清浓度,其后分别于第3、5 d晨8点抽血检测患者的PCT血清浓度,并计算各日的PCT清除率。根据患者28 d生存情况,将患者分为生存组和死亡组,对比两组间各指标的差异,并评价各指标对患者预后的判断价值。结果两组间比较,第1d及第3 d的PCT值两组间比较无差异,第五天以后的PCT值死亡组明显高于存活组。两组间PCT清除率比较可见,死亡组各天的PCT清除率均低于存活组。结论PCT绝对值并不能作为脓毒症患者预后判断的一个良好指标,其效价甚至比常用评分标准低,但PCT清除率可以作为判断预后的一个良好指标。

Objective To observe PCT content and the relationship between PCT clearance and prognosis in ICU septic patient, and evaluate the effect of PCT content and PCT clearance on judging the prognosis in ICU septic patient. Methods 311 septic patients hospitalized in general ICU of our hospital between January 2012 and January 2014 were chosen. Patients basic conditions, vital signs and laboratory test index were collected. In the first day when the patient was included, PCT of patients was detected within 24 h, after three and five days PCT was detected too, and then PCT clearance was calculated. According to survival situation within 28 days, patients were divided into survival group and death group, all indexes in two groups were compared and their effect on prognosis was evaluated.Results There is no difference in PCT detected in three or five days between two groups, the PCT in the 5th day in death group was significantly higher than that in the surivival group. PCT clearance in death group were lower than that in survival group in each day. Conclusion PCT clearance can be used as a good indicator of prognosis compared with PCT value.