目的：探讨血清PCT、hs－CRP、WBC联合检测对脓毒症患者感染类型及病情严重程度的诊断价值。方法选取2013年7月—2015年1月收治的脓毒症患者72例为研究对象，设为脓毒症组，回顾性分析其临床资料，根据血培养结果分为G＋菌亚组和G－菌亚组，根据预后情况分为存活亚组和死亡亚组，并选取同期来院体检的54例健康者作为健康对照组，分析比较各组血清 PCT、hs－CRP及WBC水平。结果脓毒症组患者的血清PCT、hs－CRP及WBC水平均远远高于健康对照组，差异具有统计学意义（ t ＝37．832、31．303、9．836， P ＜0．01）。 G＋菌亚组患者的血清PCT、hs－CRP水平远远高于G－菌亚组，差异具有统计学意义（ t ＝18．438、2．393， P ＜0．01或＜0．05），而G＋菌亚组与G－菌亚组患者的WBC计数比较差异无统计学意义（ t ＝1．910， P ＞0．05）。脓毒症存活亚组患者的血清PCT、hs－CRP与WBC水平经治疗呈时间依赖性下降，而死亡亚组不存在时间效应，且存活亚组3项指标在各时间点检测均远远低于死亡亚组，2组间比较差异具有统计学意义（ P ＜0．01）。结论血清PCT指标对于区分脓毒症G＋菌和G－菌感染类型具有一定价值，联合检测PCT、hs－CRP、WBC有助于诊断脓毒症病情严重程度，指导早期治疗。%Objective To investigate the procalcitonin ( PCT) , hypersensitive C reactive protein ( hs-CRP) and WBC combination in detection of sepsis in patients with different type and severity of infection .Methods From July 2013 to Januar-y 2015 , 72 cases of sepsis patients were selected as the research object , enrolled as sepsis group , retrospective analyzed the clinical data, according to the blood culture results, they were divided into G +bacteria subgroups and G -bacteria subgroup, according to prognosis , they were divided into survival subgroup and death subgroup , and selected the same period 54 cases of healthy persons as healthy control group , to analyze and compare the levels of serum PCT , hs-CRP and WBC levels .Results In patients with sepsis , serum PCT, hs-CRP and WBC levels were much higher than those in healthy control group , the differ-ence were statistical significance ( t =37.832, t =31.303, t =9.836, P <0.01).G+bacteria subgroup patients'serum PCT, hs-CRP level were much higher than that of the G -bacteria subgroup , the difference were statistical significance ( t =18.438, t =2.393, P <0.01 or<0.05), and G+bacteria subgroup and G -subgroup's WBC count had no statistical signifi-cance differences ( t =1.910, P >0.05).Sepsis survival subgroup's serum PCT, hs-CRP and WBC were presented with time dependent decrease after treatment , and death subgroup has no time effect , and survival subgroup's 3 indexes were much more lower than death subgroup in each time point , the difference between the two groups were statistical significance ( P <0.01).Conclusion The index of serum PCT in distinguish between G +and G-bacterial infection type for septic patients have a better clinical value .PCT, hs-CRP and WBC combined examination can help for evaluating the severity of sepsis and guide the early treatment .
展开▼
