降钙素原对脓毒症患者预后影响的临床研究

Clinical research on the effect of prognosis in patients with septicopyemia by procalcitonin

目的探讨降钙素原(procalcitonin,PCT)监测对脓毒症患者的影响。方法采用回顾性研究方法,选择2014年1月—2015年11月黑龙江省医院的脓毒症患者26例,分为监测PCT组(试验组)和未监测PCT组(对照组),观察两组治疗前后急性生理学与慢性健康状况评分系统Ⅱ(acute physiology and chronic health evaluationⅡ,APACHEⅡ)评分和序贯器官衰竭评分(sequential organ failure assessment,SOFA)等。分析PCT等因素对脓毒症患者预后的影响。两组间比较采用独立样本t检验,组内比较采用配对t检验;计数资料比较采用Fisher确切概率法,P<0.05为差异有统计学意义。结果两组患者治疗后SOFA、APACHEⅡ评分[(5.86±1.89)、(4.15±2.23)分与(17.14±7.42)、(11.32±6.91)分]比较,差异均有统计学意义(均P<0.05)。试验组治疗前后SOFA、APACHEⅡ评分比较,差异均有统计学意义(t=2.444、2.234,均P<0.05)。试验组的生存率为92.31%(12/13),对照组为69.23%(9/13),比较差异有统计学意义(P<0.05)。结论 PCT是确诊细菌感染的金标准,用于监测抗生素疗效,可随时调整抗生素,可判定脓毒症患者的预后,有助于降低脓毒症病死率。

Objective To explore the effect of the monitoring of procalcitonin（PCT） in patients with septicopyemia. Methods Referring to retrospective research method, 26 cases of patients with sepsis in Heilongjiang hospital from January 2014 to November 2015 were chosen, and they were assigned into PCT monitoring（observation group） and PCT without monitoring（control group）. Acute physiology and chronic health evaluation Ⅱ （APACHE Ⅱ ） assessment and sequential organ failure assessment （SOFA） of the two groups before and after treatment were observed. The influence of PCT and other factors on the prognosis of patients with sepsis was analyzed.Measurement data was processed by independent-samples t test and paired samples t test, count data was used by Fisher exact probability, P〈0.05 was considered statistically significant. Results After treatment, the scores of SOFA, APACHE ]] in control group were （5.86 ± 1.89）, （17.14±7.42） were significant lower than observation group[（4.15 ± 2.23）, （11.32± 6.91）]. There were differences of scores of SOFA, APACHE Ⅱin observation group before and after treatment（t=2.444,2.234,all P〈0.05）. The Survival rate of the experimental group was 92.31%（12/13）, which was significant higher than that of the control group of 69,23%（9/13）（P〈0.05）.Conelusion PCT is the gold standard for the diagnosis of bacterial infection. It can be used to monitor the efficacy of antibiotics, adjust the antibiotics at any time, determine the prognosis of patients with sepsis, and reduce the mortality rate of sepsis.