目的:探讨Pcv-aCO_2对失血性休克患者液体复苏后氧合障碍的预测价值。方法:2015年2月至2015年12月共33例失血性休克患者纳入研究,根据复苏前后肺泡动脉氧分压差分为氧合障碍组(n=16)和无氧合障碍组(n=17)。绘制受试者工作特征曲线分析...目的:探讨Pcv-aCO_2对失血性休克患者液体复苏后氧合障碍的预测价值。方法:2015年2月至2015年12月共33例失血性休克患者纳入研究,根据复苏前后肺泡动脉氧分压差分为氧合障碍组(n=16)和无氧合障碍组(n=17)。绘制受试者工作特征曲线分析氧代谢指标(血乳酸、中心静脉氧饱和度、Pcv-aCO_2、6小时乳酸清除率)、开始复苏时间、APACHE II评分等对失血性休克患者液体复苏后氧合障碍的预测价值。结果:氧合障碍组开始复苏时间显著长于无氧合障碍组(P<0.05)。氧合障碍组入组时中心静脉氧饱和度显著低于无氧合障碍组(P<0.05)。氧合障碍组入组时Pcv-aCO_2显著高于无氧合障碍组(P<0.05)。入组时Pcv-aCO_2、开始复苏时间、入组时血乳酸ROC曲线下面积分别为0.805(95%CI:0.657-0.953)、0.767(95%CI:0.584-0.949)、0.653(95%CI:0.462-0.843)。当入组时Pcv-aCO_2取临界值9.5 mm Hg时,敏感性和特异性分别为85.7%、81.5%。结论:入组时Pcv-aCO_2是预测失血性休克患者液体复苏后氧合障碍的良好指标。当入组时Pcv-aCO_2取临界值9.5mm Hg时,敏感性和特异性分别为85.7%、81.5%。展开更多
[Objective] In this study, the quantitive detection of PCV2 （porcine circovirus type 2） in vitro was achieved. We aimed to establish two kinds of TaqMan real-time PCR methods based on PCV20RF1 and ORF2 respectively ...[Objective] In this study, the quantitive detection of PCV2 （porcine circovirus type 2） in vitro was achieved. We aimed to establish two kinds of TaqMan real-time PCR methods based on PCV20RF1 and ORF2 respectively and compare them. [Method] According to the relatively＇conserved sequences of PCV20RF1 and ORF2 registered in GenBank, two pairs of specific primers and TaqMan probes were designed and synthesized. Then the recombinant plasmids containing the whole sequences of PCV20RF1 and ORF2 were constructed to draw the standard curves through optimizing the reaction system and conditions. And thus two kinds of TaqMan real-time PCR detection methods based on the whole sequences of ORF1 and ORF2 respectively were constructed for PCV2. [Result] For the two established standard curves, the Ct values showed a good linear relationship with the loga- rithms of copy numbers of templates （F2〉0.99）. The amplification efficiency ranged from 90% to 110%. The amplifications all had a good repeatability with variation coefficients within groups all less than 5%. Moreover, the amplifications all had a good specificity. When the sequences of porcine parvovirus （PPV）, porcine circovirus type 1 （PCV1）, swine pseudorabies virus （PRV）, porcine reproductive and respiratory syndrome virus （PRRSV） were used as templates, the target sequence was not amplified. The amplifications also had a high sensitivity. The ORF1 detection method could reach 1.0x10T copies/;ul, and the ORF2 detection method could reach 1.0×10^2 copies/μl. The two established real-time PCR detection methods were used to detect the 80 clinical samples respectively. The results showed the magnitudes of 72 amplified samples were basically consistent between the 2 detection methods, while the magnitudes of the other 8 amplified samples were inconsistent. Then the 8 samples were detected with SYBR Green I real-time PCR method established based on the sequence of PCV2-1ike factor P1 by Wen et aL The PCV2-1ike factor P1 was amplified in all the 8 samples, indicating the 8 samples were all infected with PCV2-1ike factor P1. [Conclusion] The ORFl-based detection method has a higher accuracy, and it can be used for the rapid detection of PCV2.展开更多
目的 探讨中心静脉-动脉血二氧化碳分压差值（Pcv-aCO2）在评估严重脓毒症患者预后中的临床价值.方法收集入住我院ICU 96例经过早期液体复苏治疗后中心静脉血氧饱和度（ScvO2）≥70%的严重脓毒症患者的APACHEⅡ评分、ScvO2、6 h Pcv-aCO...目的 探讨中心静脉-动脉血二氧化碳分压差值（Pcv-aCO2）在评估严重脓毒症患者预后中的临床价值.方法收集入住我院ICU 96例经过早期液体复苏治疗后中心静脉血氧饱和度（ScvO2）≥70%的严重脓毒症患者的APACHEⅡ评分、ScvO2、6 h Pcv-aCO2、6 h动脉血乳酸清除率和预后的相关资料.按预后不同将患者分为存活组（n=61）和死亡组（n=35）;以Pcv-aCO2 6 mm Hg为界分为高Pcv-aCO2组（≥6 mm Hg,n=40）和低Pcv-aCO2组（〈6 mm Hg,n=56）,比较存活组与死亡组、高Pcv-aCO2组与低Pcv-aCO2组之间相关数值的差异.结果 各组治疗前APACHEⅡ评分、ScvO2、动脉血乳酸比较差异均无统计学意义（P〉0.05 ）.存活组6 h Pcv-aCO2（3.15±1.54） mm Hg,明显低于死亡组[（8.34±1.89）mm Hg,P〈0.01];低Pcv-aCO2组病死率（28.57%）明显低于高Pcv-aCO2组（47.50%,P〈0.05）.存活组和低Pcv-aCO2组6 h血乳酸清除率（26.54±11.21）%和（28.16±12.39）%,明显高于死亡组[（14.96±10.93）%]和高Pcv-aCO2组[（13.82±13.54）%,均P〈0.01].6 h Pcv-aCO2与6 h血乳酸清除率呈负相关（r=-0.719,P〈0.01）.结论早期Pcv-aCO2可作为评估严重脓毒症患者预后的一个指标.展开更多
目的探讨中心静动脉血二氧化碳分压差（Pcv—aCO2）和早期乳酸清除率在评估感染性休克患者预后中的临床意义。方法选取2010-01—2013—10收住我院重症医学科的82例经早期目标导向治疗（EGDT）达标的感染性休克患者进行前瞻性观察研究，...目的探讨中心静动脉血二氧化碳分压差（Pcv—aCO2）和早期乳酸清除率在评估感染性休克患者预后中的临床意义。方法选取2010-01—2013—10收住我院重症医学科的82例经早期目标导向治疗（EGDT）达标的感染性休克患者进行前瞻性观察研究，记录入院6hPcv—aCO2及患者入院后第-个24h急性生理学和慢性健康状况评分系统Ⅱ（acute physiology and chronic health evaluationⅡ，APACHEⅡ）评分和全身性感染相关性器官衰竭（SOFA）评分；并记录入院时、人院6h、入院24h动脉血乳酸，计算早期乳酸清除率；以入院6hPcv—aCO2高低分为两组：A组（Pcv—aCO2〈6mmHg）和B组（Pcv—aCO2≥6mmHg），比较两组患者乳酸清除率、SOFA评分及病死率。以6h乳酸清除率高低分为两组：c组（乳酸清除率≤10％）和D组（乳酸清除率〉10％），比较两组患者的28天病死率。根据28天病程转归分为死亡组（32例）和存活组（50例），比较两组患者不同时间动脉血乳酸浓度、APACHEⅡ评分。结果B组较A组乳酸清除率低，SOFA评分及病死率高，入院6hPcv—aCO2与6h乳酸清除率存在负相关（r=-0．324，P=0．003）。D组病死率低于C组（P〈0．05）。存活组APACHEⅡ评分较死亡组高，而入院时、6h、24h动脉血乳酸浓度均低于死亡组（P〈0．05）。结论6hPcv—aC02和6h乳酸清除率可作为判断感染性休克患者预后的指标。展开更多
文摘目的:探讨Pcv-aCO_2对失血性休克患者液体复苏后氧合障碍的预测价值。方法:2015年2月至2015年12月共33例失血性休克患者纳入研究,根据复苏前后肺泡动脉氧分压差分为氧合障碍组(n=16)和无氧合障碍组(n=17)。绘制受试者工作特征曲线分析氧代谢指标(血乳酸、中心静脉氧饱和度、Pcv-aCO_2、6小时乳酸清除率)、开始复苏时间、APACHE II评分等对失血性休克患者液体复苏后氧合障碍的预测价值。结果:氧合障碍组开始复苏时间显著长于无氧合障碍组(P<0.05)。氧合障碍组入组时中心静脉氧饱和度显著低于无氧合障碍组(P<0.05)。氧合障碍组入组时Pcv-aCO_2显著高于无氧合障碍组(P<0.05)。入组时Pcv-aCO_2、开始复苏时间、入组时血乳酸ROC曲线下面积分别为0.805(95%CI:0.657-0.953)、0.767(95%CI:0.584-0.949)、0.653(95%CI:0.462-0.843)。当入组时Pcv-aCO_2取临界值9.5 mm Hg时,敏感性和特异性分别为85.7%、81.5%。结论:入组时Pcv-aCO_2是预测失血性休克患者液体复苏后氧合障碍的良好指标。当入组时Pcv-aCO_2取临界值9.5mm Hg时,敏感性和特异性分别为85.7%、81.5%。
基金Supported by National Natural Science Foundation of China(31302071)Special Fund for Agro-scientific Research in the Public Interest(201303046)+1 种基金Jiangsu Agricultural Science and Technology Innovation Fund(CX(14)2045)"333 High-level Personnel Training Project"of Jiangsu Province(BRA2012194)~~
文摘[Objective] In this study, the quantitive detection of PCV2 （porcine circovirus type 2） in vitro was achieved. We aimed to establish two kinds of TaqMan real-time PCR methods based on PCV20RF1 and ORF2 respectively and compare them. [Method] According to the relatively＇conserved sequences of PCV20RF1 and ORF2 registered in GenBank, two pairs of specific primers and TaqMan probes were designed and synthesized. Then the recombinant plasmids containing the whole sequences of PCV20RF1 and ORF2 were constructed to draw the standard curves through optimizing the reaction system and conditions. And thus two kinds of TaqMan real-time PCR detection methods based on the whole sequences of ORF1 and ORF2 respectively were constructed for PCV2. [Result] For the two established standard curves, the Ct values showed a good linear relationship with the loga- rithms of copy numbers of templates （F2〉0.99）. The amplification efficiency ranged from 90% to 110%. The amplifications all had a good repeatability with variation coefficients within groups all less than 5%. Moreover, the amplifications all had a good specificity. When the sequences of porcine parvovirus （PPV）, porcine circovirus type 1 （PCV1）, swine pseudorabies virus （PRV）, porcine reproductive and respiratory syndrome virus （PRRSV） were used as templates, the target sequence was not amplified. The amplifications also had a high sensitivity. The ORF1 detection method could reach 1.0x10T copies/;ul, and the ORF2 detection method could reach 1.0×10^2 copies/μl. The two established real-time PCR detection methods were used to detect the 80 clinical samples respectively. The results showed the magnitudes of 72 amplified samples were basically consistent between the 2 detection methods, while the magnitudes of the other 8 amplified samples were inconsistent. Then the 8 samples were detected with SYBR Green I real-time PCR method established based on the sequence of PCV2-1ike factor P1 by Wen et aL The PCV2-1ike factor P1 was amplified in all the 8 samples, indicating the 8 samples were all infected with PCV2-1ike factor P1. [Conclusion] The ORFl-based detection method has a higher accuracy, and it can be used for the rapid detection of PCV2.
文摘目的 探讨中心静脉-动脉血二氧化碳分压差值（Pcv-aCO2）在评估严重脓毒症患者预后中的临床价值.方法收集入住我院ICU 96例经过早期液体复苏治疗后中心静脉血氧饱和度（ScvO2）≥70%的严重脓毒症患者的APACHEⅡ评分、ScvO2、6 h Pcv-aCO2、6 h动脉血乳酸清除率和预后的相关资料.按预后不同将患者分为存活组（n=61）和死亡组（n=35）;以Pcv-aCO2 6 mm Hg为界分为高Pcv-aCO2组（≥6 mm Hg,n=40）和低Pcv-aCO2组（〈6 mm Hg,n=56）,比较存活组与死亡组、高Pcv-aCO2组与低Pcv-aCO2组之间相关数值的差异.结果 各组治疗前APACHEⅡ评分、ScvO2、动脉血乳酸比较差异均无统计学意义（P〉0.05 ）.存活组6 h Pcv-aCO2（3.15±1.54） mm Hg,明显低于死亡组[（8.34±1.89）mm Hg,P〈0.01];低Pcv-aCO2组病死率（28.57%）明显低于高Pcv-aCO2组（47.50%,P〈0.05）.存活组和低Pcv-aCO2组6 h血乳酸清除率（26.54±11.21）%和（28.16±12.39）%,明显高于死亡组[（14.96±10.93）%]和高Pcv-aCO2组[（13.82±13.54）%,均P〈0.01].6 h Pcv-aCO2与6 h血乳酸清除率呈负相关（r=-0.719,P〈0.01）.结论早期Pcv-aCO2可作为评估严重脓毒症患者预后的一个指标.
文摘目的探讨中心静动脉血二氧化碳分压差（Pcv—aCO2）和早期乳酸清除率在评估感染性休克患者预后中的临床意义。方法选取2010-01—2013—10收住我院重症医学科的82例经早期目标导向治疗（EGDT）达标的感染性休克患者进行前瞻性观察研究，记录入院6hPcv—aCO2及患者入院后第-个24h急性生理学和慢性健康状况评分系统Ⅱ（acute physiology and chronic health evaluationⅡ，APACHEⅡ）评分和全身性感染相关性器官衰竭（SOFA）评分；并记录入院时、人院6h、入院24h动脉血乳酸，计算早期乳酸清除率；以入院6hPcv—aCO2高低分为两组：A组（Pcv—aCO2〈6mmHg）和B组（Pcv—aCO2≥6mmHg），比较两组患者乳酸清除率、SOFA评分及病死率。以6h乳酸清除率高低分为两组：c组（乳酸清除率≤10％）和D组（乳酸清除率〉10％），比较两组患者的28天病死率。根据28天病程转归分为死亡组（32例）和存活组（50例），比较两组患者不同时间动脉血乳酸浓度、APACHEⅡ评分。结果B组较A组乳酸清除率低，SOFA评分及病死率高，入院6hPcv—aCO2与6h乳酸清除率存在负相关（r=-0．324，P=0．003）。D组病死率低于C组（P〈0．05）。存活组APACHEⅡ评分较死亡组高，而入院时、6h、24h动脉血乳酸浓度均低于死亡组（P〈0．05）。结论6hPcv—aC02和6h乳酸清除率可作为判断感染性休克患者预后的指标。
