血清PCT、CRP、WBC在脓毒症患者病情及预后评估中的应用价值

Application value of serum PCT,CRP,WBC in assessing the condition and prognosis of patients with sepsis

目的探讨血清降钙素原(PCT)、C-反应蛋白(CRP)、白细胞计数(WBC)在脓毒症患者病情及预后评估中的应用价值。方法选择2016年1月~2017年12月我院收治的116例脓毒症患者作为研究对象,其中77例脓毒症(脓毒症组),21例严重脓毒症(严重脓毒症组),18例脓毒性休克(脓毒性休克组)。观察比较三组血清PCT、CRP、WBC水平、患者入院治疗2周后的生存状况及各指标水平,分析三组血清PCT与CRP、WBC水平之间的关系。结果三组的PCT、CRP和WBC水平比较,差异有统计学意义(P<0.01);随着脓毒症病情的加重,患者的PCT、CRP和WBC水平均明显升高(P<0.01)。经2周治疗后,有83例病情好转,25例无效,8例死亡。其中死亡组的PCT、CRP和WBC水平均显著高于无效组和好转组,且无效组的PCT、CRP和WBC水平明显高于好转组(P<0.01)。Pearson相关性分析结果显示:患者血清CRP及WBC均和PCT成正相关(r>0,P<0.01),且CRP与PCT的相关性>WBC。结论血清PCT、CRP和WBC水平与脓毒症患者病情严重程度密切相关,其水平越高,患者病情越严重,预后也越差,且CRP和PCT的评估水平优于WBC。

Objective To explore the value of serum procalcitonin（PCT）, C-reactive protein（CRP） and white blood cell count（WBC） in the evaluation of the condition and prognosis of sepsis patients. Methods One hundred and sixteen patients with sepsis admitted to our hospital from January 2016 to December 2017 were selected. Among them, they were further divided into sepsis group（n=77）, severe sepsis group（n=21）, and septic shock group（n=18）. The serum levels of PCT, CRP, and WBC, band the survival status of the patients after 2 weeks of hospitalization and the corresponding indexes in the three groups were observed and compared. The correlations between serum PCT and CRP, and PCT and WBC were analyzed. Results The levels of PCT, CRP and WBC in the three groups were significantly different（P〈0.01）. As the severity of sepsis increased, the levels of PCT, CRP, and WBC increased significantly（P〈0.01）. After 2-week treatment, 83 patients improved their conditions, 25 cases were invalid, and 8 cases died. The PCT, CRP, and WBC levels in the death cases were significantly higher than those in the invalid and improved cases. The PCT, CRP,and WBC levels in invalid cases were significantly higher than those in the improved cases（P〈0.01）. The Pearson correlation analysis showed that serum CRP and WBC were both positively correlated with PCT（r0, P〈0.01）, and the correlation between CRP and PCT was greater than that between WBC and PCT. Conclusion Serum PCT, CRP and WBC levels are all closely related to the severity of sepsis. The higher the levels, the more severe the patient′s condition is, and the worse the prognosis is. The evaluation level of CRP and PCT is better than that of WBC.