血清endocan和降钙素原对脓毒症早期诊断及预后判断的临床价值

Clinical value of serum endocan and calcitonin in early diagnosis and prognosis of sepsis

目的探讨血清endocan和降钙素原对脓毒症早期诊断及预后判断的临床价值。方法选择2018年1月—2019年1月我院急诊科收治的脓毒症或全身炎症反应综合征(SIR S)患者110例,根据诊断标准将患者分为SIRS组(30例)和脓毒症组(80例),脓毒症患者再按病情严重程度分为一般脓毒症组(20例)、严重脓毒症组(26例)、脓毒性休克组(34例)。患者入院当日、第3天采集清晨空腹静脉血采用双抗体免疫夹心法测定PCT,同时在当日根据最差指标评定患者的急性生理与慢性健康状况评分(APACHEⅡ)和24 h内序贯器官衰竭评分(SOFA)。比较SIRS组与脓毒症各亚组间endocan、PCT、APACHEⅡ评分、SOFA评分的差异,分析endocan、PCT对脓毒症早期诊断与预后判断的价值。结果脓毒症组血清endocan、PCT水平、APACHEⅡ评分、SOFA评分均明显高于SIRS组(P<0.05);在脓毒症组中,严重脓毒症、脓毒症休克组血清endocan、PCT水平、APACHEⅡ评分、SOFA评分明显高于一般脓毒症组;脓毒症休克组血清endocan、PCT水平、APACHEⅡ评分、SOFA评分明显高于严重脓毒症组(P<0.05)。结论血清endocan和降钙素原对脓毒症早期诊断及预后判断的临床价值高。

Objective To investigate the clinical value of serum endocan and calcitonin in early diagnosis and prognosis of sepsis. Methods From January 2018 to January 2019,110 cases of sepsis or systemic inflammatory response syndrome(SIRS)were selected. According to the diagnostic criteria,the patients were divided into SIRS groups (30 cases)and sepsis groups(80 cases). The patients with sepsis were divided into general sepsis group(20 cases), severe sepsis group(26 cases),and septic shock group(34 cases)according to the condition of Yanzhongchengdu. On the day of admission and the third day of the patient's morning fasting vein blood was collected to determine the patient's PCT,and the double antibody immunosandwich method was used for detection. At the same time,the patient's APACHEⅡ score(acute physiological and chronic health score)and SOFA score (24 h internal organ failure score) were assessed on the same day based on the worst indicators. Comparing the difference of endocan,PCT,APACHE Ⅱ score and SOFA score between the SIR group and the subgroups of sepsis,the value of endocan and PCT in early diagnosis and prognosis of sepsis was analyzed. Results The serum endocan,PCT level,APACHEⅡ score and SOFA score of sepsis group were significantly higher than those of SIR group,P<0.05;In the sepsis group,the serum endocan, PCT level,APACHEⅡ score,and SOFA score of severe sepsis,sepsis shock group were significantly higher than those of the general sepsis group;Serum endocan,PCT level,APACHEⅡ score and SOFA score in sepsis shock group were significantly higher than those in severe sepsis group,P<0.05. Conclusion serum endocan and calcitonin have high value in early diagnosis and prognosis of sepsis.