降钙素原在脓毒症病情评估和预后判断中的应用价值

摘要

目的：探讨降钙素原在脓毒症病情评估和预后判断中的应用价值。方法选取2009年8月~2014年6月本院重症监护病房收住的感染危重患者200例,其中脓毒症组140例,局部感染组60例,脓毒症患者根据病情轻重分为休克组和非休克组,根据预后分为生存组和死亡组,入科后进行APACHEⅡ评分,监测患者血清PCT水平及动态变化,并进行比较分析。结果脓毒症组和局部感染组首次PCT水平比较差异有统计学意义(P<0.01)；非休克组和休克组首次PCT水平、APACHEⅡ评分比较差异有统计学意义(P<0.01)。生存组PCT水平呈下降趋势,死亡组PCT水平呈缓慢上升趋势,并维持较高水平。结论血清PCT水平对脓毒症的早期诊断、严重程度及预后评估具有较高的灵敏度和特异度,PCT水平的动态变化可作为评估病情、判断预后及调整治疗方案的依据,在脓毒症诊疗过程中有重要价值。%Objective To investigate application value of procalcitonin in condition assessment and prognosis judgment of sepsis. Methods 200 patients with severe sepsis admitted our hospital of intensive care unit from August 2009 to June 2014 were selected,including sepsis group of 140 cases,local infection group of 60 cases.According to the sepsis patient’s illness severity,the patients with sepsis were classified into shock group and non-shock group.According to the sepsis patient’s prognosis,the patients with sepsis were classified into survival group and death group.After the subject, APACHEII score was applied.Serum PCT and the dynamic change of patients with sepsis infection were monitored, compared and analyzed. Results There was statistical difference on the level of first PCT between sepsis group and lo-cal infection group (P<0.01).There were statistical difference on the level of first PCT,APACHEII score between shock group and non-shock group (P<0.01).The level of PCT in survival group decreased,the level of PCT in death group in-creased slowly,and maintain a higher level. Conclusion The level of serum PCT has a high sensitivity and specificity for early diagnosis,assessment of severity and prognosis of sepsis.The dynamic change of the PCT level can be used as basis of condition assessment,prognosis and adjust the treatment plan,which has a significant value in sepsis treatment process.