降钙素原对ICU全身炎症反应综合征患者病因诊断及预后的价值

The value of procalcitonin in etiological diagnosis and prognosis of patients with ICU systemic inflammatory response syndrome

目的探讨分析ICU全身炎症反应综合征患者测定降钙素原后对其病因诊断及预后的价值。方法选择我院2015年1月~2016年12月收治的80例ICU全身炎症反应综合征患者(脓毒症),作为实验组,另外选取同时期来我院ICU就诊的80非脓毒症患者作为对照组,两组患者均进行外周静脉血血清降钙素原(PCT)、c-反应蛋白(CRP)测定,观察两组患者的PCT、CRP动态测定效果,针对死亡组与存活组患者的PCT、CRP动态测定效果进行对比分析,并且分析影响预后的危险因素。结果经测定分析,实验组ICU全身炎症反应综合征患者在第1天、第3天、第5天的PCT水平均高于对照组,两组差异有统计学意义(P<0.05),CRP水平差异无统计学意义;另外,所有入选患者中,有119例患者存活,41例患者死亡,死亡组患者在第1天、第3天、第5天的PCT水平均高于存活组,两组差异有统计学意义(P<0.05),CRP水平差异无统计学意义;针对PCT水平进行分析,当PCT水平大于5.3μg/L时是影响预后的独立危险因素。结论降钙素原对于诊断ICU全身炎症反应综合征具有非常好的意义,并且可通过分析其水平评估预后效果,对于患者的健康非常重要。

Objective To investigate the value of determination of procalcitonin in etiological diagnosis and prognosis of patients with systemic inflammatory response syndrome（ICU）. Methods Eighty patients with ICU systemic inflammatory response syndrome（sepsis） in our hospital were selected as experimental group from January 2015 to December 2016.In addition,80 non-sepsis patients who visited our hospital during the same period of time were selected as the control group.The serum procalcitonin（PCT） and c-reactive protein（CRP） were measured in both groups. The effect of dynamic determination of CRP in two groups was observed,the effect of dynamic determination of CRP in death group and survival group was compared and analysed,and prognostic risk factors was analysed. Results The levels of PCT in patients with systemic inflammatory response syndrome（ICU） in experimental group were higher than those in control group at day 1,day 3,day 5,and there was no significant difference between the two groups（P〈0.05）.There was no significant difference in CRP.In addition,there were 119 patients who survived and 41 patients died.The PCT levels of the patients in the death group were higher than those in the survival group 1 D,3 D,5 D.There was no significant difference between the two groups（P〈0.05）.There was no significant difference in CRP.According to the analysis of PCT level,when PCT level is higher than 5.3μg/L,it is an independent risk factor for prognosis. Conclusion Procalcitonin is very useful in the diagnosis of systemic inflammatory response syndrome in ICU,and it is very important for the health of the patient to evaluate the prognosis effect by analyzing its level.