D-D、cf-DNA、PCT与脓毒症患者病情及预后的关系

Relationship between D-D,cf-DNA,PCT and the condition and prognosis Of patients with sepsis

目的探讨血浆D-二聚体(D-D)、游离DNA、血清降钙素原(PCT)与脓毒症患者病情及预后的关系。方法选取西安交通大学第二附属医院确诊的脓毒症患者114例,根据病情程度将其分为脓毒症组78例、严重脓毒症组36例,检测对比两组的血浆D-D、游离DNA、血清PCT水平,并根据患者治疗28 d后的出院结局情况将其分为死亡组和存活组进行对比;采用线性相关分析法分析血浆D-D、游离DNA、血清PCT与急性生理功能与慢性健康(APACHEⅡ)评分、序贯器官衰竭(SOFA)评分的关系。结果严重脓毒症患者的APACHEⅡ评分、SOFA评分显著高于脓毒症组患者,差异均具有统计学意义(P<0.05);严重脓毒症患者的血浆D-D、游离DNA、血清PCT显著高于脓毒症组患者,差异均具有统计学意义(P<0.05);经过治疗,28d内死亡的脓毒症患者的血浆D-D、游离DNA、血清PCT显著高于存活组患者,差异均具有统计学意义(P<0.05);脓毒症患者的血浆D-D、游离DNA、血清PCT与患者APACHEII评分、SOFA评分均呈正相关关系(P<0.05)。结论血浆D-D、游离DNA、血清PCT与脓毒症患者的病情、预后密切相关,对于指导临床治疗有一定的参考价值。

Objective To investigate the relationship between plasma D-dim er(D-D),free DNA,serum procalcitonin(PCT)and the condition and prognosis of patients with sepsis.Methods 114 patients with sepsis diagnosed in our hospital were divided into 78 patients with sepsis and 36 patients with severe sepsis according to the severity of the disease.The plasma DD,free DNA and serum PCT levels were compared between the two groups.According to the dist.harge outcome after 28 days of treatment,the patients were divided into the death group and ihe survival group for comparison.The linear correlation analysis method was used to analyze plasma DD,free DNA,serum PCT and acute physiological function and chronic health(APACHE Ⅱ)score,sequential organs.The relationship between exhaustion(SOFA)scores.Results The APACHE Ⅱ score and SOFA score of patients with severe sepsis were significantly higher than those of the sepsis group(P<0.05).The plasma DD,free DNA and serum PCT of patients with severe sepsis were significantly higher than those of pus.In the toxic group,the difference was statistically significant(P<0.05).After treatment,the plasma DD,free DNA,and serum PCT of patients with sepsis who died within 28 clays were significantly higher than those of the surviving group.The difference was stalistically significant.(P<0.05);plasma DD,free DNA,serum PCT were positively correlated with APACHE Ⅱ score and SOFA score in patients with sepsis(P<0.05).Conclusion Plasma D-D,free DNA,and serum PCT are closely related to the condition and prognosis of patients with sepsis,and have certain reference value for guiding clinical treatment.