降钙素原、超敏C反应蛋白及D-二聚体在脓毒症所致急性呼吸窘迫综合征中的诊断和预后评估价值

Value of procalcitonin, high-sensitivity C-reactive protein and D-dimer in diagnosis and prognosis of acute respiratory distress syndrome caused by sepsis

目的探究降钙素原(PCT)、超敏C反应蛋白(hs-CRP)及D-二聚体在脓毒血症所导致的急性呼吸窘迫综合征(ARDS)中的诊断及预后评估价值。方法选取2015年1月~2017年1月于海南医学院第一附属医院治疗的脓毒症导致的ARDS患者82例,按照患者严重程度将其分为重症组(33例)与非重症组(49例),按照患者结局将其分为非死亡组(69例)与死亡组(13例),另选取同期100例健康体检者为健康对照组,分别对几组患者的血清PCT、hs-CRP及D-二聚体水平进行评测和比较。结果血清PCT、hs-CRP及D-二聚体水平,重症组>非重症组>健康对照组,差异有统计学意义(P<0.05);血清PCT、hs-CRP及D-二聚体水平,死亡组>非死亡组>健康对照组,差异有统计学意义(P<0.05);相关性分析显示,血清PCT、hs-CRP及D-二聚体水平与患者预后呈正相关(r=0.634、0.518、0.537,P<0.05)。结论血清PCT、hs-CRP及D-二聚体水平与脓毒症所致ARDS病情和预后具有一定相关性,血清因子水平越高,患者病情越重、预后越差。

Objective To investigate the value of diagnosis and prognostic evaluation on acute respiratory distress syndrome(ARDS)caused by sepsis and procalcitonin(PCT),high-sensitivity C-reactive protein(hs-CRP),D-dimer.Methods From January 2015 to January 2017,in the First Hospital Affiliated to Hainan Medical College,82 sepsis-causing ARDS patients were selected.According to the severity of patients,they were divided into severe group(33 cases)and non-severe group(49 cases),according to the ending of patients,they were divided into non-death group(69 cases)and death group(13 cases).At the same period,100 healthy physical examinations were selected as healthy control group.Serum PCT,hs-CRP,and D-dimer levels in the group were evaluated and compared.Results Serum PCT,hs-CRP,and D-dimer levels in Severe group>non-severe group>healthy control group,the differences were statistically significant(P<0.05);serum PCT,hs-CRP and D-dimer levels in death group>non-death group>healthy control group,the differences were statistically significant(P<0.05).Correlation analysis revealed that serum PCT,hs-CRP and D-dimer levels were positively correlated with patient outcome(r=0.634,0.518,0.537,P<0.05).Conclusion Serum PCT,hs-CRP,and D-dimer levels are associated with sepsis-induced ARDS disease and prognosis.The more severe the patient′s condition and the worse the prognosis,the higher the above-mentioned serum factor levels.