HBP、PCT、CRP测定在肺炎合并脓毒症中的诊断价值

Diagnostic value of HBP,PCT and CRP in pneumonia complicated with sepsis

目的观察肺炎合并脓毒症患者的肝素结合蛋白(HBP)、降钙素原(PCT)、C反应蛋白(CRP)水平和血流动力学指标,并分析其临床意义。方法选取2018年11月-2019年10月在我院接受治疗的肺炎患者为研究对象,根据其是否合并脓毒症分为合并脓毒症组和未合并脓毒症组。观察合并脓毒症组和未合并脓毒症组患者以及不同预后患者HBP、PCT和CRP水平、血流动力学水平的差异。结果合并脓毒症组患者的HBP、PCT和CRP水平分别为102.56±7.82 ng/mL、32.26±3.95 ng/mL、l44.75±9.01 mg/L,高于未合并脓毒症组(t=16.484、-57.118、-45.619,P<0.001);合并脓毒症组患者的MAP、CVP水平分别为69.25±3.16mmHg、6.11±1.32 cmH2O,低于未合并脓毒症组(t=67.064、21.137,P<0.001);死亡组患者的HBP、PCT和CRP水平分别为128.34±8.02 ng/mL、41.28±5.14 ng/mL、168.24±12.87 mg/L,高于非死亡组患者(r=21.557、-37.393、-32.639,P<0.001);死亡组患者的MAP、CVP水平分别为60.24±6.34 mmHg、6.98±1.17 cmHp,低于非死亡组患者(t=13.829、6.963,P<0.001)。结论肺炎合并脓毒症患者的HBP、PCT和CRP水平较高,MAP、CVP水平较低,且与患者的预后密切相关。

Objective To observe the levels of HBP,PCT,CRP and hemodynamics in patients with pneumonia com plicated with sepsis,and to analyze its clinical significance.Methods Pneumonia patients who were treated in our hospital from November 20 to October 2019 were enrolled in the study.They were divided into sepsis group and sepsis group according to whether they were complicated with sepsis.The differences in HBP,PCT and CRP levels and hemodynamics were observed between patients with sepsis and those without sepsis and patients with different prognosis.Results The levels of HBP,PCT and CRP in the patients with sepsis were 102.56±7.82 ng/mL,32.26±3.95 ng/mL and 144.75±9.01 mg/L,respectively,which was higher than those without sepsis(t=-16.484,-57.118,-45.619,P<0.001);MAP and CVP levels in patients with sepsis were 69.25±3.16 mmHg and 6.11±1.32 cmH2O,respectively,lower than those without sepsis(t=67.064,21.137,P<0.001);HBP,PCT and CRP levels in the death group were 128.34±8.02 ng/mL,41.28±5.14 ng/mL,168.24±12.87 mg/L,respectively,higher than non-dead patients(t=-21.557,-37.393,-32.639,P<0.001);MAP and CVP levels in the death group were 60.24±6.34 mmHg and 6.98±1.17 cmH2O,respectively,which were lower than those in the non-dead group(t=13.829,6.963,P<0.001).Conclusion Patients with pneumonia complicated with sepsis have higher levels of HBP,PCT and CRP,lower levels of MAP and CVP,and are closely related to the prognosis of patients.