首页|血清CRP、PCT及NICOM参数与感染性休克患者容量管理的相关性

血清CRP、PCT及NICOM参数与感染性休克患者容量管理的相关性

扫码查看
目的 研究血清 C 反应蛋白(CRP)、降钙素原(PCT)及无创心排血量监测技术(NICOM)参数与感染性休克(SS)患者容量管理的相关性.方法 选取2021年6月至2023年6月许昌市中心医院收治的SS患者72例作为研究对象,均接受容量负荷试验(VE),以VE后心排血指数增加值(ΔCI)≥10%定义为容量反应阳性(有反应组,n=45),ΔCI<10%定义为容量反应阴性(无反应组,n=27).比较两组基线资料、VE前后CI、血清CRP、PCT水平、NICOM参数[心排血量(CO)、外周血管阻力指数(sVRI)],分析血清CRP、PCT水平、CO、sVRI与容量管理的关联性.结果 无反应组VE前后血清CRP、PCT水平高于有反应组,CO、sVRI、CI低于有反应组,差异有统计学意义(P<0.05).VE前后血清CRP、PCT与CI呈负相关,CO、sVRI与CI呈正相关(P<0.05).VE前血清CRP、PCT水平、CO、sVRI是SS患者容量反应性阴性(ΔCI)的独立影响因素(P<0.05).结论 SS患者容量管理与血清CRP、PCT水平、NICOM参数密切相关,早期明确各指标水平有利于临床评估容量反应性、及时调整治疗方案.
Study on the relationship between serum CRP,PCT,NICOM parameters and volume management in patients with septic shock
Objective To study the relationship between serum C⁃reactive protein(CRP),procal⁃citonin(PCT),non⁃invasive cardiac output monitoring technology(NICOM)parameters and volume manage⁃ment of patients with septic shock(SS).Methods From June 2021 to June 2023,72 patients with SS in our hospital were selected as the research objects,and all of them underwent volume expansion test(VE).The in⁃crease in cardiac output index after VE(ΔCI)≥10%was defined as positive volume response(reactive group,n=45),and ΔCI<10%was defined as negative volume response(non⁃reactive group,n=27).The baseline data,CI before and after VE,serum CRP,PCT levels,NICOM parameters[cardiac output(CO),systemic vascular resistance index(sVRI)]were compared between the two groups.The correlation between serum CRP,PCT levels,CO,sVRI and volume management was analyzed.Results The serum CRP and PCT levels before and after VE in the non⁃reactive group were higher than those in the reactive group,and CO,sVRI,and CI were lower than those in the reactive group(P<0.05).Serum CRP and PCT before and after VE were nega⁃tively correlated with CI,and CO and sVRI were positively correlated with CI(P<0.05).Multivariate logistic multiple linear regression analysis showed that serum CRP,PCT levels,CO and sVRI before VE were still inde⁃pendent influencing factors related to negative volume responsiveness(ΔCI)in SS patients(P<0.05).Conclu⁃sion Volume management in SS patients is closely related to serum CRP,PCT and NICOM parameters.Early identification of the levels of various indicators can be beneficial for the clinical evaluation of volume responsive⁃ness and the timely adjustment of the treatment plan.

CRPPCTNICOMSS

张世杰、栗付民、韩灵龙

展开 >

许昌市中心医院麻醉科,河南,许昌 461000

C反应蛋白 降钙素原 无创心排血量监测技术 感染性休克

河南省医学科技攻关计划项目

2020082493

2024

分子诊断与治疗杂志
中山大学

分子诊断与治疗杂志

CSTPCD
影响因子:0.65
ISSN:1674-6929
年,卷(期):2024.16(10)