血清PCT、CRP动态监测在ICU脓毒症患者诊疗中的应用价值

Evaluating the Value of Dynamic Monitoring of Serum Procalcitonin and C-reactive Protein in ICU Patients with Sepsis

目的:对ICU脓毒症患者中血清降钙素原(PCT)、C反应蛋白(CRP)进行动态监测,为临床诊疗提供参考依据。方法:采用病例对照研究,以入住本院ICU诊断为脓毒血症患者42例作为实验组,非脓毒症患者40例为对照组,分别于入院后第1、3、5、7 d检测血清PCT、CRP水平,并用ROC曲线评价PCT、CRP对脓毒症的诊断效能。结果:脓毒症患者组第1、3、5、7 d血清PCT、CRP显著高于对照组,差异均有统计学意义(P<0.01);且治疗后,血清PCT、CRP水平逐渐下降,第5 d显著下降,但到第7 d仍保持一定水平。ROC曲线评价血清PCT、CRP诊断脓毒症效能显示,其AUC分别为0.977、0.910。分别以CRP=3.625 mg/L、PCT=1.84 ng/m L作为最佳截断值时,其对脓毒症患者的诊断效果最佳。结论:对ICU脓毒症患者行血清PCT、CRP监测,其结果对脓毒症的诊断及其预后具有重要价值,可为临床诊疗提供可靠参考。

Objective ： To evaluate the clinical application value of dynamic monitoring of serum procalcitonin and C- reactive protein levels in the intensive care unit （ICU） patients with sepsis, Methods： Patients with sepsis in the ICU was 42 （test group） and 40 non-sepsis individuals were selected as controls （control group）.PCT and CRP levels were evaluated on days 1, 3, 5, and 7. The diagnostic performance of CRP and PCT was determined by the receiver operat- ing characteristic curve （ROC）. Results ： The serum levels of PCT and CRP in the test group were higher than those in the control group on days I , 3, 5 and 7 （P〈0.01）. After treatment, PCT and CRP levels decreased gradually in the Sep- sis group. They decreased significantly on the fifth day, but remained at a high level on the seventh day. The ROC AUC of PCT and CRP were 0.977 and 0.910 respecfively. When the cut-off value of PCT and CRP was 1.84 μg/L and 3.625 mg/L, It has the best diagnosis effect on patients with sepsis. Conclusion： Dynamic monitoring of serum proealcitonin and C-reactive protein has important clinical application value for Diagnosis and prognosis of ICU patients with sepsis.