脓毒症患者血清降钙素原、炎症因子水平与APACHEⅡ、SOFA评分的相关性

Correlation between serum PCT,inflammatory factors and APACHE Ⅱ,SOFA Scores in patients with sepsis

目的:研究脓毒症患者血清降钙素原(PCT)、炎症因子水平与急性生理及慢性健康评分(APACHEⅡ)、序贯器官衰竭评估(SOFA)评分的相关性。方法:选择2016年12月至2018年1月承德医学院附属医院收治的125例脓毒症患者作为研究对象,根据检查结果分为脓毒症组(40例)、严重脓毒症组(45例)和脓毒性休克组(40例);另选取50例体检健康者作为对照组。比较4组的PCT水平、炎症因子、APACHCEⅡ、SOFA评分,并行PCT、炎症因子水平与APACHEⅡ、SOFA评分相关性分析。结果:脓毒症组、严重脓毒症组、脓毒性休克组的PCT、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)水平显著高于对照组(P<0.05);脓毒症组PCT、IL-6、TNF-α、CRP水平显著低于严重脓毒症组、脓毒性休克组(P<0.05);严重脓毒症组PCT、IL-6、TNF-α、CRP水平显著低于脓毒性休克组(P<0.05)。脓毒性休克组APACHCEⅡ、SOFA评分显著高于脓毒症组、严重脓毒症组(均P<0.05));严重脓毒症组APACHCEⅡ、SOFA评分显著高于脓毒症组(P<0.05)。PCT、IL-6水平与APACHEⅡ、SOFA评分呈正相关(P<0.05);TNF-α、CRP水平与APACHEⅡ呈正相关(P<0.05),而与SOFA评分无相关性(P>0.05)。结论:血清PCT、IL-6水平与APACHEⅡ、SOFA评分有良好的相关性,可更好地反映脓毒症患者的病情严重程度和预后情况。

Objective: To study the correlation between serum PCT,inflammatory factors and APACHE Ⅱ,SOFA scores in patients with sepsis.Methods: A total of 125 patients with sepsis treated in our hospital from December 2016 to January 2018 were selected as our objects.According to the examination results,they were divided into sepsis group(40 cases),severe sepsis group(45 cases),septic shock group(40 cases);another 50 cases of healthy physical examination were as control group.The PCT and inflammatory factors,APACHE Ⅱ,SOFA scores of the four groups were compared,and the correlation analysis of PCT and inflammatory factors with Apache Ⅱ and SOFA scores was performed.Results: PCT,IL-6,TNF-α and CRP in the sepsis group,the severe sepsis group and the septic shock group after treatment were significantly higher than those in the control group;PCT,IL-6,TNF-α and CRP in the sepsis group were significantly lower than those in the severe sepsis group and the septic shock group;PCT,IL-6,TNF-α and CRP in the severe sepsis group were significantly lower than those in the septic shock group(P<0.05).APACHCE Ⅱ and SOFA scores in the septic shock group were significantly higher than those in the sepsis and severe sepsis groups;APACHCE Ⅱ and SOFA scores in the severe sepsis group were significantly higher than those in the sepsis group.The differences were statistically significant(P<0.05).PCT was positively correlated with APACHE Ⅱ and SOFA scores(P<0.05);IL-6 was positively correlated with APACHE Ⅱand SOFA scores(P<0.05);TNF-α and CRP were positively correlated with APACHEII scores(P <0.05).However,TNF-α and CRP were not correlated with SOFA scores(P>0.05).Conclusion: Serum PCT and IL-6 have a good correlation with APACHE Ⅱ and SOFA scores,which can better reflect the severity and prognosis of patients with sepsis.