降钙素原、血小板及D-二聚体检测在脓毒症预后中的价值

The prognostic value of the serum levels of procalcitonin,platelet and D-dimer in patients with sepsis

目的:探讨脓毒症病人血清降钙素原、血小板及D-二聚体等指标在脓毒症病人预后中的价值。方法:选取脓毒症病人45例,其中非脓毒性休克组25例,脓毒性休克组20例,另选择同期住院的非脓毒症病人25例作为对照组。病人入院24～48h内完成降钙素原、血小板及D-二聚体水平的检测,并进行相关数据分析。结果:脓毒症组降钙素原及D-二聚体水平均高于对照组,血小板水平低于对照组(P <0. 01)。脓毒性休克组降钙素原及D-二聚体水平高于非脓毒性休克组,血小板水平低于非脓毒性休克组(P <0. 01)。脓毒症组三项指标与预后明显相关,预后良好组降钙素原及D-二聚体低于预后不良组,血小板高于预后不良组(P <0. 01)。相关分析显示,脓毒症组降钙素原与SOFA评分、APACHEⅡ评分呈显著正相关关系,血小板与二者呈显著负相关关系。结论:降钙素原、血小板及D-二聚体水平可作为脓毒症严重程度评价及预后预测的指标。

Objective： To explore the prognostic value of the serum levels of procalcitonin（ PCT）,platelet（ PLT） and D-dimer in patients with sepsis. Methods： Forty-five patients with sepsis were divided into the non-septic shock group（ 25 cases） and septic shock group（ 20 cases）,and 25 patients without sepsis were set as the control group. The levels of PCT,PLT and D-dimer in three groups were detected within 24 to 48 h of admission,and analyzed. Results： The levels of PCT and D-dimer in sepsis group were higher than those in control group,and the PLT level in sepsis group was lower than that in control group,and the difference of which was statistically significant（ P〈0. 01）. The levels of PCT and D-dimer in septic shock group were higher than those in non-septic shock group,and the PLT level in septic shock group was lower than that in non-septic shock group,and the difference of which was statistically significant（ P〈0. 01）. The three indexes in sepsis group were significantly correlated with prognosis,the PCT and D-dimer levels in patients with good prognosis were lower than those in patients with poor prognosis,and the PLT levelsin patients with good prognosis were higher than those in patients with poor prognosis（ P〈0. 01）. Correlation analysis showed the PCT level was significantly positively correlated with the scores of SOFA and APACHEⅡ,and the PLT level was significantly negatively correlated with the scores of SOFA and APACHEⅡin sepsis group. Conclusions： The levels of PCT,PLT and D-dimer can be used as the predictors of evaluating the severity and prognosis of sepsis.