脓毒症休克患者Lac、PCT、CRP、RDW水平的变化及其临床意义

Changes and clinical significance of lactate,procalcitonin,C-reactive protein,and red blood cell distribution width levels in patients with septic shock

目的分析脓毒症休克患者乳酸(Lac)、降钙素原(PCT)、C-反应蛋白(CRP)、红细胞分布宽度(RDW)水平的变化及其临床意义。方法回顾性分析2017年1月至2021年1月在惠州市第三人民医院急诊医学科治疗的80例脓毒症患者的临床资料,按照临床转归分为非休克组(46例)与脓毒性休克组(34例),比较两组患者的Lac、PCT、CRP、RDW水平。按照脓毒症患者住院28 d之后的生存状况分为死亡组(25例)与存活组(55例),比较两组患者的Lac、PCT、CRP、RDW水平。采用Logistic多因素回归分析法分析影响脓毒性休克患者预后危险因素。结果脓毒性休克组患者的Lac、PCT、CRP、RDW水平分别为(5.86±1.69)mmol/L、(42.06±13.31)ng/mL、(141.27±38.09)mg/L、(18.86±4.02)%,明显高于非休克组的(3.27±1.03)mmol/L、(23.72±5.91)ng/mL、(105.36±30.12)mg/L、(16.16±3.31)%,差异均具有统计学意义(P<0.05);死亡组患者的Lac、PCT、CRP、RDW水平分别为(6.45±2.11)mmol/L、(44.57±10.42)ng/mL、(156.34±39.82)mg/L、(19.74±4.23)%,明显高于存活组的(2.47±0.62)mmol/L、(21.68±6.91)ng/mL、(97.79±29.73)mg/L、(16.22±3.41)%,差异均有统计学意义(P<0.05);经Logistic多因素回归分析结果显示,Lac、PCT、CRP、RDW水平升高是脓毒症患者出现脓毒性休克及死亡的独立危险因素(P<0.05)。结论脓毒性休克患者Lac、PCT、CRP、RDW水平明显高于非休克患者,脓毒性休克死亡患者的Lac、PCT、CRP、RDW水平明显高于存活患者,且Lac、PCT、CRP、RDW水平升高是预测脓毒症患者出现脓毒性休克及死亡的独立危险因素。

Objective To analyze the changes of lactate(Lac),procalcitonin(PCT),C-reactive protein(CRP),and red blood cell distribution width(RDW)levels and their clinical significance in patients with septic shock.Methods The clinical data of 80 sepsis patients treated in the Department of Emergency Medicine,Huizhou Third People's Hospital from January 2017 to January 2021 were retrospectively analyzed.According to clinical outcomes,they were divided into non-shock group(46 cases)and septic shock group(34 cases).The levels of Lac,PCT,CRP,and RDW were compared between the two groups.Sepsis patients were divided into death group(25 cases)and survival group(55 cases)according to their survival status after 28 days of hospitalization.The levels of Lac,PCT,CRP,and RDW were compared between the two groups.Logistic multivariate regression analysis was used to analyze the prognostic risk factors of patients with septic shock.Results Lac,PCT,CRP,RDW in the septic shock group were(5.86±1.69)mmol/L,(42.06±13.31)ng/mL,(141.27±38.09)mg/L,(18.86±4.02)%,which were significantly higher than(3.27±1.03)mmol/L,(23.72±5.91)ng/mL,(105.36±30.12)mg/L,(16.16±3.31)% in the non-shock group,with statistically significant differences(P<0.05).The levels of Lac,PCT,CRP,and RDW in the death group were(6.45±2.11)mmol/L,(44.57±10.42)ng/mL,(156.34±39.82)mg/L,(19.74±4.23)%,significantly higher than(2.47±0.62)mmol/L,(21.68±6.91)ng/mL,(97.79±29.73)mg/L,(16.22±3.41)%in the survival group,with statistically significant differences(P<0.05).Logistic multivariate regression analysis showed that elevated levels of Lac,PCT,CRP,and RDW were independent risk factors for septic shock and death in sepsis patients(P<0.05).Conclusion The levels of Lac,PCT,CRP,and RDW in patients with septic shock are significantly higher than those in non-shock patients,the levels of Lac,PCT,CRP,and RDW in patients who died of septic shock are significantly higher than those in patients who survived.Increased levels of Lac,PCT,CRP,and RDW are independent risk factors for predicting septic shock and death in patients with sepsis.