不同预后脓毒症患者血清降钙素原、C反应蛋白与凝血功能指标和APACHE Ⅱ评分的关系分析

Analysis of the Relationship between Serum Procalcitonin, C-reactive Protein and Coagulation Function and APACHE Ⅱ Score in Sepsis Patients with Different Prognosis

目的:探讨不同预后脓毒症患者血清降钙素原(PCT)、C反应蛋白(CRP)与凝血功能指标和急性生理和慢性健康状况评分系统Ⅱ(APACHEⅡ)评分的关系。方法:回顾性分析2015年1月至2019年1月期间深圳市第二人民医院重症医学科收治的160例脓毒症患者(脓毒症组)与在深圳市第二人民医院接受住院治疗的160例非脓毒症患者(非脓毒症组)的临床资料,根据脓毒症组患者住院28d后的预后情况分为存活组118例和死亡组42例,比较脓毒症组和非脓毒症组以及死亡组和存活组患者血清PCT和CRP水平、APACHE II评分以及凝血功能指标,采用Pearson相关性回归分析脓毒症患者血清降钙素原和CRP水平与APACHEⅡ评分以及凝血功能指标相关性。结果:与非脓毒症组相比,脓毒症组的血清PCT和CRP水平以及APACHEⅡ评分明显升高,凝血酶原时间(PT)和部分凝血活酶时间(APTT)明显延长(均P<0.05)。与存活组相比,死亡组的血清PCT和CRP水平以及APACHEⅡ评分明显升高,而PT和APTT均明显延长(均P<0.05)。Pearson相关性回归分析结果显示,血清PCT和CRP水平与APACHEⅡ评分、PT及APTT均呈正相关(均P<0.05)。结论:脓毒症患者血清PCT和CRP水平异常升高,APACHEⅡ评分及凝血功能指标均与血清PCT和CRP水平呈正相关,检测血清PCT和CRP水平有助于评估脓毒症患者的预后。

Objective: To evaluate the relationship between serum procalcitonin, C-reactive protein of sepsis patients with different prognosis and coagulation function index and acute physiology and chronic health status scoring system Ⅱ(APACHE Ⅱ) score.Methods: The clinical data of 160 patients with sepsis(sepsis group) who were admitted to the critical medicine department of Shenzhen Second People’s Hospital and 160 patients with non sepsis(non sepsis group) who were hospitalized in Shenzhen Second People’s Hospital from January 2015 to January 2019 were analyzed retrospectively, the sepsis group patients were divided into survival group with 118 cases and death group with 42 cases according to their prognosis status 28 days after hospitalization. The levels of serum PCT and CRP,APACHE II score and coagulation function were compared between sepsis group and non-sepsis group, death group and survival group.Pearson correlation regression was used to analyze the correlation between levels of serum procalcitonin and CRP and APACHE II score and coagulation function in sepsis patients. Results: Compared with non-sepsis group, the levels of serum PCT and CRP and APACHE II scores in sepsis group increased significantly, while prothrombin time(PT) and activated partial thromboplastin time(APTT) prolonged significantly(all P<0.05). Compared with the survival group, the levels of serum PCT and CRP and APACHE II scores in the death group were significantly higher, while PT and APTT were significantly prolonged(all P<0.05). Pearson correlation regression analysis showed that the levels of serum PCT and CRP were positively correlated with APACHE II score, PT and APTT(all P<0.05). Conclusion: The levels of serum PCT and CRP are abnormally elevated in sepsis patients. APACHE II score and coagulation function are positively correlated with the levels of serum PCT and CRP. Detection of the levels of serum PCT and CRP are helpful to evaluate the prognosis of sepsis patients.