Cys C对脓毒症患者生存状况的预测价值

Value of Cys C to predict survival in patients with sepsis

目的探讨脓毒症患者入ICU时的血Cys C水平对患者病情及预后的评估意义。方法回顾性分析2016年7月~2017年7月我院ICU收治的107例脓毒症诊断成立48h以内的患者为研究对象,按照患者住院期间的预后情况分为存活组(n=50)及死亡组(n=57)。比较两组患者入ICU 24h内的血PCT、BUN、SCr、Cys C及APACHEⅡ评分,并绘制ROC曲线分析上述各指标预测脓毒症患者病情及预后的价值。结果两组患者性别构成及年龄组间比较均无统计学差异(P>0.05);两组患者入住ICU 24h内的APACHEⅡ、PCT、BUN、SCr、Cys C等指标,死亡组均高于存活组,差异有统计学意义(P<0.05);脓毒症患者入ICU 24h内的APACHEⅡ、PCT、BUN、SCr、Cys C水平对预测患者住院期间死亡情况的ROC曲线分析显示:APACHEⅡ、PCT、BUN、SCr、Cys C曲线下面积分别为0.748、0.694、0.698、0.722、0.772,以APACHEⅡ≥23.5、PCT≥37.46 ng/ml、BUN≥11.65 mmol/L、SCr≥124.55μmol/L、Cys C≥1.91mg/L为截断点,其预测脓毒症患者住院期间死亡的灵敏度和特异度分别为61.4%、54.4%、66.7%、68.4%、57.9%和78%、80%、68%、76%、88%。结论脓毒症患者进入ICU时的血Cys C水平可用于指导评估患者的病情及预后。

Objective To investigate the significance of serum Cys C level in patients with sepsis on the condition and prognosis of patients in ICU. Methods A retrospective analysis of 107 patients with sepsis within 48 hours from Jul 2016 to Jul 2017 in ICU of our hospital was carried out. According to the prognosis of the patients in hospital,the patients were divided into survival group（n=50） and death group（n=57）. The score of blood APACHE Ⅱ and Cys C of patients in ICU within 24 hours were compared. The ROC curve was plotted to analyze the value of the above indexes in predicting the condition and prognosis of sepsis patients. Results There was no significant difference in gender and age between two groups（P〈0.05）. The value of APACHE Ⅱ,PCT,BUN,SCr,Cys C in death group were significant higher than survival group（P〈0.05）. The area under the ROC curve of APACHE Ⅱ,PCT,BUN,SCr,Cys C were 0.748,0.694,0.698,0.722,0.772 respectively,using APACHE Ⅱ≥23.5,PCT≥37.46 ng/ml BUN≥11.65 mmol/L,SCr≥124.55μmol/L,Cys C≥1.91 mg/L as the cut-off point,the sensitivity of each index to predict the death rate of sepsis patients were 61.4%,54.4%,66.7%,68.4%,57.9% respectively,and their specificity were 78%,80%,68%,76%,88%. Conclusion The level of blood Cys C in patients with sepsis when entering ICU can be used as an ideal indicator for guiding the assessment of the patients＇ condition and prognosis.