降钙素原、胆碱酯酶及心肌肌钙蛋白Ⅰ在脓毒症患者病情及预后评估中的应用价值

Application value of procalcitonin,cholinesterase and cardiac troponin Ⅰ in the evaluation of disease degree and prognosis of sepsis patients

目的探讨降钙素原(PCT)、胆碱酯酶(CHE)及心肌肌钙蛋白Ⅰ(cTnⅠ)在脓毒症患者病情及预后评估中的应用价值,为脓毒症的临床诊断与预后评估提供依据。方法选取2014年5月至2016年6月黄冈市中心医院收治的脓毒症患者114例,按照病情程度将患者分为脓毒症组(n=47)、严重脓毒症组(n=42)和脓毒性休克组(n=25),再根据患者生存状况将其分为死亡组(n=23)和生存组(n=91),对各组患者血清PCT、CHE和cTnⅠ水平进行比较。结果脓毒性休克组患者血清PCT和cTnⅠ水平显著高于严重脓毒症组和脓毒症组(P<0.05),严重脓毒症组患者血清PCT和cTnⅠ水平显著高于脓毒症组(P<0.05)。脓毒性休克组患者血清CHE水平显著低于严重脓毒症组和脓毒症组(P<0.05),严重脓毒症组患者血清CHE水平显著低于脓毒症组(P<0.05)。死亡组患者血清PCT和cTnⅠ水平显著高于生存组(P<0.05),CHE水平显著低于生存组(P<0.05)。结论血清PCT、CHE和cTnⅠ水平检测对评估脓毒症患者病情程度及预后有重要意义。

Objective To investigate the application value of procalcitonin（ PCT）,cholinesterase（ CHE） and cardiac troponin I（ cTnⅠ） in the evaluation of disease degree and prognosis of sepsis patients,so as to provide the basis for clinical diagnosis and prognostic evaluation of sepsis. Methods A total of 114 patients with sepsis were selected in Huanggang Central Hospital from May 2014 to June 2016. The patients were divided into sepsis group（ n = 47）,severe sepsis group（ n = 42） and septic shock group（ n = 25） according to the severity of the disease. The patients were divided into death group（ n = 23） and survival group（ n = 91） according to the survival status. The levels of serum PCT,CHE and cTnⅠ were compared in the groups.Results The levels of serum PCT and cTnⅠ in septic shock group were significantly higher than those in severe sepsis group and sepsis group（ P 0. 05）. The levels of serum PCT and cTnⅠ in severe sepsis group were significantly higher than those in sepsis group（ P 0. 05）. The level of serum CHE in septic shock group was significantly lower than that in severe sepsis group and sepsis group（ P 0. 05）,and the serum CHE level in severe sepsis group was significantly lower than that in sepsis group（ P 0. 05）. The levels of serum PCT and cTnⅠ in the death group were significantly higher than those in the survival group（ P 0. 05）,and the serum CHE level in the death group was significantly lower than that in the survival group（ P 0. 05）.Conclusion The levels of serum PCT,CHE and cTnⅠ are important in evaluating the severity and prognosis of patients with sepsis.