降钙素原及APACHEⅡ评分对脓毒症的临床价值
Procalcitonin and APACHEⅡScore of Clinical Assessment for Sepsis
金银 1顾金华 1钱福初1
作者信息
- 1. 浙江省湖州市中心医院检验科,313000
- 折叠
摘要
目的:观察血清降钙素原( procalcitonin,PCT)对脓毒症的早期诊断、监测病情的临床应用价值及其与急性生理学及慢性健康状况评分 ( acute physiology and chronic health evaluationⅡ,APACHEⅡ评分)之间的相关性.方法:回顾性分析脓毒症组56例和非脓毒症组30例均在入院当天用抗生素前采血检测PCT和C-反应蛋白(CRP)及进行APACHEⅡ评分,在治疗后第1d、3d和7d分别复查,并根据28d病死率将患者分为存活组与死亡组.结果:脓毒症组PCT、CRP水平和APACHEⅡ评分均明显高于非脓毒症组,差异有统计学意义(P<0.05);治疗后第3d开始,存活组PCT、CRP水平随病情好转迅速下降,而死亡组虽有下降趋势,但仍持续高水平,PCT水平和APACHEⅡ评分显著高于存活组(P<0.05),PCT水平与APACHEⅡ评分的相关系数0.66(P<0.05).结论:血清PCT对脓毒症早期诊断、监测病情有重要的临床价值,而APACHEⅡ评分与其有较强的相关性.联合APACHEⅡ评分可作为对脓毒症患者病情严重程度及预后评估的一个可靠指标.
Abstract
Objective To observe of serum procalcitonin(PCT) for clinical applicative value in its early diagnosis and monitoring of sepsis as well as the correlation between acute physiology and chronic health evaluation (APACHE Ⅱ score) and PCT. Methods A retrospective analysis of 56 patients with sepsis group and non sepsis group 30 cases were scored by blood sampling detection of PCT and C-reactive protein( CRP) and APACHE Ⅱ before using antibiotics on the day of hospitalization. On the first, third and seventh day of treatment, the patients respectively reviewed were divided into survival group and death group according to the 28-day mortality. Re-sults PCT, CRP levels and APACHE Ⅱ score of the sepsis group were significantly higher than those in non sepsis group,and the differences showed statistically significance (P <0.05) ; 3 days after treatment, the PCT and CRP levels of the survival group decreased rapidly with the condition improved while remained higher than normal levels in the death group despite the downward trend; PCT level and APACHE Ⅱ, with its correlation coefficient 0.66 (P<0.05), scored significantly higher than those of the survival group (P <0.05). Conclusion PCT indicated important clinical value for early diagnosis of sepsis and condition monitoring. APACHE Ⅱ combined with PCT,can be used as a reliable index for evaluating the severity and prognosis of patients with sepsis.
关键词
血清降钙素原/慢性健康状况评分/脓毒症/C-反应蛋白Key words
serum procalcitonin/APACHE Ⅱ score/sepsis/CRP引用本文复制引用
出版年
2013
NETL
NSTL
维普
万方数据