乳酸、降钙素原、N-端脑利钠肽及D-二聚体对脓毒症预后的分析

Prognostic Significance of Serum Lactic Acid, Procalcitonin,D-Dimer, N-terminal Pro-B-type Natriuretic Peptide in Patients With Sepsis

目的比较血清乳酸、降钙素原、N-端脑利钠肽、D-二聚体及急性生理学与慢性健康评分Ⅱ对脓毒症患者预后的预测价值。方法收集2012年1月—2017年1月长春中医药大学附属医院急诊ICU科收治的符合脓毒症诊断标准患者62例,记录生命体征及各项检查指标,总结APACHE-Ⅱ评分,根据其预后分为生存组与死亡组,对相关数据进行统计学分析。结果 4种标记物及APACHE-Ⅱ评分在两组患者中均有显著差异,对死亡的预测有较高的敏感性与特异性,ROC曲线下面积为0.726~0.781之间。结论血清乳酸、降钙素原、N-端脑利钠肽及D-二聚体对脓毒症患者的死亡有预测价值,联合监测可提高预测的敏感性。

Objective To investigate the prognostic significance of serum lactic acid, procalcitonin, D-Dimer, N-terminal pro-B-type natriuretic peptide and APACHE- Ⅱ scores in patients with sepsis. Methods 62 septic patients from the affiliated hospital of Changchun Traditional Chinese Medicine University between January 2012 to January 2017 who met sepsis defnition criteria were divided into survival group and non-survival group according to their outcome. Vital signs and laboratory dates were recorded, APACHE-Ⅱ were scored. The results were analyzed statistically. Results There were signifcant differences in levels of 4 biomarkers and APACHE-Ⅱ score between 2 groups. For biomarkers had area under the curve （AUC） around 0.726~0.781. Conclusion Serum lactic acid, procalcitonin, D-Dimer and N-terminal pro-B-type natriuretic peptide are all good biomarkers for estimating patients prognosis and combined estimation can increase the sensitivity.