降钙素原和D-二聚体对老年脓毒症的诊断价值

The diagnosis value of procalcitonin and D-dimer for elderly patients with sepsis

目的检测老年脓毒症患者血清降钙素原(PCT)和D-二聚体(D-D)水平,分析其临床意义,为临床早期诊断及预后评估提供依据。方法选择本院老年脓毒症患者126例,作为观察组,其中脓毒症48例(观察组A)、重度脓毒症41例(观察组B)及脓毒症休克37例(观察组C);所有纳入病例中存活96例(存活组)、死亡30例(死亡组)。选取同期住院其他老年患者130例,作为对照组。检测各组血清PCT、D-D浓度。结果观察组患者血清PCT和D-D分别为(18.15±1.12)μg/L和(3.70±0.58)mg/L,均高于对照组,差异有统计学意义(P<0.05);观察组C患者血清PCT和D-D分别为(22.68±0.98)μg/L和(4.74±0.63)mg/L,均高于观察组B和观察组A,观察组B血清PCT和D-D高于观察组A,差异有统计学意义(P<0.05)。观察组患者治疗后血清PCT和D-D分别为(11.37±0.85)μg/L和(2.09±0.61)mg/L,均低于治疗前,差异有统计学意义(P<0.05);死亡组患者血清PCT和D-D分别为(23.06±1.14)μg/L和(4.81±0.63)mg/L,均高于存活组,差异有统计学意义(P<0.05)。结论老年脓毒症患者血清PCT和D-D显著升高,并随着严重程度呈递增趋势,治疗后显著降低,对于早期诊断、病情程度及预后评估具有重要的临床意义。

Objective Analyze the clinical significance of serum procalcitonin（PCT）and D-dimer（D-D）level of elderly sepsis patients,and provide basis for early diagnosis and prognosis assessment. Methods 126 patients with sepsis were selected for the study and divided into 48 sepsis（observation group A）,41 with severe sepsis（observation group B）and 37 with sepsis shock（observation group C）. Among all the selected patients,96 survived（survival group）and 30 died（death group）. 130 elderly patients without sepsis were selected during the same period as the control group. The concentrations of serum D-D and PCT were measured. Results The level of serum PCT and D-D of the observation groups were respectively（18.15±1.12）μg/L and（3.70±0.58）mg/L,significantly higher than those of the control group（P〈0.05）. The level of serum PCT and D-D of observation group C were respectively（22.68±0.98）μg/L and（4.74±0.63）mg/L,significantly higher than those of the observation group B and observation group A;serum PCT and D-D levels of observation group B were significantly higher than those of observation group A（P〈0.05）.The level of serum PCT and D-D of the observation group after treatment were（11.37±0.85）μg/L and（2.09±0.61）mg/L,respectively,significantly lower than those before treatment（P〈0.05）. The levels of serum PCT and D-D of the death group were respectively（23.06±1.14）μg/L and（4.81±0.63）mg/L,significantly higher than those of the survival group（P〈0.05）. Conclusion The levels of serum PCT and D-D of the elderly patients with sepsis increased significantly with the severity of the disease. And they were significantly reduced after treatment. Serum PCT and D-D could be used for early diagnosis and prognosis of the disease.