血清降钙素原结合病原学检查在感染性休克病人中的应用

Application of serum procalcitonin and etiology examination on diagnosis of patients with septic shock

目的观察感染性休克病人血清降钙素原(PCT)与病原学检查的变化,探讨两者结合应用在感染性休克中的临床价值。方法选择重症医学病房(ICU)收治的感染性休克病人53例,选取同期非感染性休克病人37例。抽取外周静脉血,进行血清PCT检测、病原学培养,对感染性休克病人进行APACHEⅡ评分。比较不同分组中血清PCT水平和病原学检查的差异,分析感染性休克PCT水平分布与病原学检查的关系。结果与非感染性休克病人血清PCT阳性率(35.14%)及病原学阳性率(16.22%)相比,感染性休克组血清PCT阳性率(86.79%)及病原学阳性率(75.47%)明显升高(P<0.05)。生存组血清PCT阳性率80.00%、病原学阳性率65.71%及APACHEⅡ(21.56±4.28)分,死亡组血清PCT阳性率100.00%、病原学阳性率94.44%及APACHEⅡ得分(26.49±4.65)均明显升高(P<0.05)。随着血清PCT水平等级的升高,病原学阳性率逐渐升高,差异有统计学意义(P<0.05)。病原学阴性病人血清PCT(0.68±0.27)μg·L-1,明显低于阳性病人(3.85±1.32)μg·L-1,差异有统计学意义(P<0.05)。结论血清PCT水平检测结合病原学检查可用于评估感染性休克病人的感染状况,对预后判断和治疗具有重要意义。

Objective To observe the change of serum procalcitonin(PCT)and etiology examination in septic shock patients,and discuss the application value in septic shock.Methods Choosed53patients with septic shock were admitted in our hospital ICU from June2012to June2015,also seleted37cases of non-septic shock during the same period.Detected the serum PCT,etiology check and APACHE II in patients that with septic shock.The serum PCT level and etiology checks in different group were compared,and the septic shock PCT level distribution and the relationship with etiology were analyzed.Results Compared with the serum PCT and non-septic shock patients the positive rate(35.14%),and the positive rate of pathogens(16.22%)the infection rate of septic shock group serum PCT(86.79%)positive rate and pathogen(75.47%)increased significantly(P<0.05).The survival rate of positive serum PCTwas80.00%,positivem teofpathogensw as65.71%andtheAPACHE II was(21.56±4.28).T lie d e a tlio ftlie p o sitiv e m te o f serum PCT was100.00%,positive rate of pathogens was94.44%and the APACHE II score was(26.49±4.65),which were significantly increased(P<0.05).With the increase of serum PCT level,the positive rate of pathogens increased gradually.The difference was statistically significant(P<0.05).The serum PCT was(0.68±0.27)jjig?L1of the patients with negative etiology,which was significantly lower than that of the positive patients(3.85±1.32)jjig?L1,and the difference was statistically significant(P<0.05).Conclusion Serum level of PCT detection combined with etiology examination can be used to evaluate the infection status of septic shock patients.This is of great significance to the prognosis and treatment.