联合降钙素原和D－二聚体检测对急诊感染患者病情判断的临床意义

摘要

Objective To evaluate disease severity of emergency infectious patients by combining of procalcition and D-dimer.Methods By a review of the infectious patients admitted in emergency department between April, 2012 to March, 2013, we collected the results of procalcition and D-dimer when the patients arrived in the hospital, and also got the APACHEⅡ score in the first 24 hours.We wanted to find out the relationship among procalcition, D-dimer and APACHEⅡ score. Results The clinical data of 464 patients were collected.The results of procalcition, D-dimer and APACHEⅡscores were analyzed by linear correlation, and we discovered that there was a positive linear correlation between each of them.Grouped by the results of procalcition or D-dimer respectively, we found that the score of APACHEⅡincreased with the data of them.Grouped the patients by combination of the procalcition and D-dimer, we divided them into three groups.Group A was both the procalcition and D-dimer increased, group B was one of them increased, and group C was none increased.We found that the acute physiology score in the group A was higher than the other groups ( P <0.05 ) . Conclusion There are positive linear correlations between procalcition, D -dimer and APACHEⅡscore in emergency infectious patients.And it is helpful to emergency doctor to judge disease severity using the ligation of procalcition and D-dimer.%目的：探讨对急诊感染患者进行降钙素原（ PCT）、D－二聚体检测判断疾病严重程度的临床意义。方法选择2012－04～2014－03就诊于我院急诊内科的感染患者，回顾分析患者就诊时PCT和D－二聚体，并在患者就诊后24 h内进行急性生理和慢性健康状况评分Ⅱ（ APACHEⅡ），观察PCT、D－二聚体与APACHEⅡ评分的关系。结果共收入464例患者，所有患者的PCT、D－二聚体与APACHEⅡ评分呈正线性相关性。以患者PCT和D－二聚体检测结果进行分组，发现随着检测值的升高，APACHEⅡ评分也有所增加。 PCT和D－二聚体均升高的患者APACHEⅡ评分中急性生理学状态评分明显高于单一项目升高组与两项均不升高组（ P＜0.05）。结论急诊感染患者的PCT和D－二聚体与APACHEⅡ评分具有正线性相关性。联合检测PCT和D－二聚体，有助于急诊医师判断感染患者的严重程度。