Objective To analyze the clinical value of peripheral vascular resistance index (systemic vascular resistance index, SVRI) combined with plasma procalcitonin (PCT) in the early diagnosis of sepsis, and to provide refer-ence for the early treatment of the disease in order to improve the prognosis of patients. Methods From January 2012 to January 2016, 284 patients suspected of infection in our hospital in accordance with the inclusion criteria were select-ed as research objects. All the patients underwent SVRI and PCT detection. The diagnosis of sepsis was made based on the critical values of SVRI and PCT in the diagnosis of sepsis, which were set according to ROC curve. The specificity, sensitivity, and accuracy of SVRI combined with PCT were evaluated. Results PCT levels in patients with sepsis, se-vere sepsis, and septic shock were (7.69±0.67)μg/L, (16.47±1.35)μg/L, (23.14±1.84)μg/L, respectively, which were sig-nificantly higher than (0.32±0.10)μg/L in patients without sepsis (P<0.05), and the PCT levels in septic shock were sig-nificantly higher than those in sepsis and severe sepsis (P<0.05). SVRI levels in patients with sepsis, severe sepsis, and septic shock were (156.75±35.52) kPa·s·L-1·m-2, (124.60±24.76) kPa·s·L-1·m-2, (108.39±15.64) kPa·s·L-1·m-2, respec-tively, which were significantly lower than (192.25 ± 54.33) kPa·s·L-1·m-2 in patients without sepsis (P<0.05), and the levels were significantly lower in septic shock than those in sepsis and severe sepsis (P<0.05), as well as in severe sepsis than sepsis (P<0.05). The specificity, sensitivity, and accuracy of SVRI combined with PCT in diagnosis of sepsis were 77.46%, 71.83%, 74.65%, significantly higher than those of single SVRI (72.87%, 63.87%, 67.96%) and single PCT (48.33%, 43.90%, 45.77%). Conclusion SVRI combined with PCT has a high clinical value in the early diagnosis of sepsis for patients with clear infection, with high sensitivity and specificity.%目的 分析外周血管阻力指数(SVRI)联合血浆降钙素原(PCT)对脓毒症(sepsis)早期诊断的临床价值,为临床及早对脓毒症病患者开展治疗提供依据,提高脓毒症患者的预后质量.方法 选择2012年1月至2016年1月无锡市第二人民医院收治的符合纳入标准的疑似感染患者284例作为研究对象,在完善各项检查后进行诊断,对患者入组时行SVRI和PCT进行检测,建立ROC曲线,根据ROC曲线设立SVRI和PCT诊断脓毒症的临界值,并根据该临界值对患者做出是否为脓毒症的判断,计算SVRI联合PCT诊断脓毒症的特异度、灵敏度和准确度.结果 一般脓毒症患者[(7.69±0.67)μg/L]、严重脓毒症[(16.47±1.35)μg/L]和脓毒症休克[(23.14±1.84)μg/L]患者的PCT明显高于非脓毒症患者[(0.32±0.10)μg/L],差异均有统计学意义(P<0.05),其中脓毒症休克患者PCT高于一般脓毒症患者和严重脓毒症患者(P<0.05),严重脓毒症患者高于一般脓毒症患者(P<0.05);一般脓毒症患者[(156.75±35.52)kPa·s·L-1·m-2]、严重脓毒症[(124.60±24.76)kPa·s·L-1·m-2]和脓毒症休克[(108.39±15.64)kPa·s·L-1·m-2]患者的SVRI明显低于非脓毒症患者[(192.25±54.33)kPa·s·L-1·m-2],差异均有统计学意义(P<0.05),其中脓毒症休克患者SVRI低于一般脓毒症患者和严重脓毒症患者(P<0.05),严重脓毒症患者SVRI低于一般脓毒症患者(P<0.05).SVRI联合PCT诊断脓毒症的特异度、灵敏度、准确度分别为77.46%、71.83%、74.65%,明显高于单纯采用SVRI(72.87%、63.87%、67.96%)和PCT诊断(48.33%、43.90%、45.77%),差异均有统计学意义.结论 SVRI联合PCT检查对明确感染的患者进行早期脓毒症诊断,灵敏度和特异度均较好,具有较高的临床价值.
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