血清PCT、凝血四项指标变化与脓毒症患者APACHE Ⅱ评分的相关性及动态监测指导意义

The Correlation Between Changes in Serum PCT,Coagulation,and APACHEⅡScores in Sepsis Patients and The Guiding Significance of Dynamic Monitoring

目的 探讨血清降钙素原(PCT)、凝血四项指标变化与脓毒症患者急性生理学及慢性健康状况(APACHEⅡ)评分的相关性及动态监测指导意义。方法 回顾性选取本院2019年2月至2022年2月收治的脓毒症患者70例为脓毒症组,根据治疗28 d预后结果 分为死亡组(25例)、存活组(45例),根据病情严重程度分为轻度25例,中度24例,重度21例。另选取同期住院的非脓毒症患者70例为非脓毒症组。所有研究对象均进行血清PCT、凝血四项指标、APACHEⅡ评分的评估,比较各组上述指标水平变化及其相关性。结果 较非脓毒症组比,脓毒症组血清PCT水平、APACHEⅡ评分较高,血浆PT、APTT、TT较长,血浆FIB水平较低;死亡组血清PCT、APACHEⅡ评分较高,血浆PT、APTT、TT较长,血浆FIB水平较低;脓毒症患者血清PCT、血浆PT、APTT、TT水平与APACHEⅡ评分呈正相关,血浆FIB水平与APACHEⅡ评分呈负相关(均P<0.05)。结论 APACHEⅡ评分可用于评估脓毒症患者病情严重程度,同时血清PCT水平、血浆PT、APTT、TT水平与APACHEⅡ评分呈正相关,血浆FIB水平与APACHEⅡ评分呈负相关,通过对患者上述指标变化情况进行动态检测能够辅助制定治疗方案,临床上有一定指导意义。

Objective To explore the correlation between the changes of serum Calcitonin(PCT),blood coagulation and the acute physiology and chronic health status(APACHEⅡ)score of sepsis patients and the significance of dynamic monitoring.Methods 70 patients with sepsis admitted to our hospital from February 2019 to February 2022 were retrospectively selected as the sepsis group.According to the 28 day prognosis,they were divided into a death group(25 cases)and a survival group(45 cases).According to the severity of the condition,they were divided into mild 25 cases,moderate 24 cases,and severe 21 cases.Another 70 non sepsis patients who were hospitalized during the same period were selected as the non sepsis group.All study subjects were evaluated for serum PCT,coagulation four indicators,and APACHEⅡscore,and the changes and correlations of the above indicators in each group were compared.Results Compared with the non sepsis group,the sepsis group had higher serum PCT levels and APACHEⅡscores,longer plasma PT,APTT,TT,and lower plasma FIB levels;The death group had higher serum PCT and APACHEⅡscores,longer plasma PT,APTT,TT,and lower plasma FIB levels;The levels of serum PCT,plasma PT,APTT,TT in sepsis patients were positively correlated with APACHEⅡscores,while the levels of plasma FIB were negatively correlated with APACHEⅡscores(all P<0.05).Conclusion The APACHEⅡscore can be used to evaluate the severity of sepsis in patients.At the same time,serum PCT levels,plasma PT,APTT,TT levels are positively correlated with the APACHEⅡscore,while plasma FIB levels are negatively correlated with the APACHEⅡscore.Dynamic detection of changes in the above indicators in patients can assist in formulating treatment plans,and has certain clinical guiding significance.