血清降钙素原(PCT)在脓毒症的早期诊断及危险分层的价值

Value of Serum Calcitonin (PCT) in the Early Diagnosis and Risk Stratification of Sepsis

目的探讨血清PCT在脓毒症的早期诊断及危险分层的价值。方法随机选取2015年5月至2017年5月我院ICU收治的脓毒症患者100例和50例健康人群,依据疾病类型将这些患者分为脓毒症组(n=50)和严重脓毒症组(n=50)两组,对两组患者的血清PCT、hs-CRP、乳酸、中性粒细胞比例、WBC及SOFA评分、血清PCT、hs-CRP、乳酸、中性粒细胞比例、WBC的ROC曲线分析、血清PCT与hs-CRP、乳酸、WBC及SOFA评分的双变量相关性分析进行统计分析。结果严重脓毒症组患者的血清PCT、hs-CRP、WBC及SOFA评分均显著高于脓毒症组(P<0.05),但两组患者的乳酸、中性粒细胞比例之间的差异均不显著(P>0.05)。两组患者的PCT的AUC显著高于hs-CRP、乳酸、中性粒细胞比例、WBC(P<0.05),敏感性、特异性均显著高于hs-CRP、乳酸、中性粒细胞比例、WBC(P<0.05),乳酸缺乏良好的检验效力(P>0.05)。两组患者的血清PCT与WBC及SOFA评分均呈显著的正相关关系(P<0.05),但与hs-CRP、乳酸均无相关性(P>0.05)。结论血清PCT在脓毒症的早期诊断及危险分层的价值高,敏感性及特异性均较高,值得在临床推广应用。

Objective To investigate the value of serum PCT in the early diagnosis and risk stratification of sepsis. Methods100 cases of patients with sepsis from May 2015 to May 2017 in ICU of our hospital and 50 healthy people were randomly selected.These patients were divided into sepsis group（ n = 50） and severe sepsis group（ n = 50） according to the types of disease cases. Serum PCT,hs-CRP,lactic acid,percentage of neutrophils,WBC and SOFA scores,serum PCT,hs-CRP,lactic acid,percentage of neutrophils,WBC ROC curve analysis,serum PCT and hs-CRP levels,WBC,bivariate correlation analysis of lactate and SOFA score of the two groups were statistically analyzed. Results Serum PCT,hs-CRP,WBC and SOFA scores of the severe sepsis group were significantly higher than those of the sepsis group（ P〈0. 05）,but the differences of lactate and neutrophil proportion between the two groups were not significant（ P〈0. 05）. The AUC of PCT of the two groups was significantly higher than hs-CRP,lactic acid,percentage of neutrophils and WBC（ P〈0. 05）. Sensitivity and specificity were significantly higher than hs-CRP,lactate,percentage of neutrophils and WBC（ P〈0. 05）,and lactate lacked good test effectiveness（ P〈0. 05）. There was a significant positive correlation between serum PCT and WBC and sofa score（ P〈0. 05）,but no correlation with hs-CRP and lactate.（ P〈0. 05）. Conclusion The value of serum PCT is high in the early diagnosis and risk stratification of sepsis,and its sensitivity and specificity are high,which is worth popularizing and application in the clinical.