重症感染患者病情危重程度与血清降钙素原、C-反应蛋白及血小板的相关性分析

摘要

目的 探讨重症感染患者病情危重程度与血清降钙素原、C-反应蛋白及血小板的相关性,以期降低感染率和感染程度.方法 回顾性分析2012年6月至2015年10月重症感染患者56例,作为研究组,其中13例住院期间死亡(死亡组),余均好转(好转组).以同时期上呼吸道感染52例作为对照组,抽取静脉血,观察在不同组别、不同时间点血清降钙素原、C-反应蛋白及血小板计数变化情况,并以APACHEⅡ评分作为感染程度与以上3个指标相关性.结果 研究组在降钙素素原、C-反应蛋白上显著高于对照组,而在血小板上则显著低于对照组,2组比较差异有统计学意义(P<0.05);入院第1天死亡组和好转组在C-反应蛋白、血小板上比较差异无统计学意义(P>0.05);而降钙素原则好转组显著低于死亡组(P<0.05),入院后第3天、入院后第7天在降钙素原、C-反应蛋白上死亡组显著高于好转组,在血小板上则显著低于好转组,2组比较差异有统计学意义(P<0.05);重症感染危重程度和降钙素原、C-反应蛋白正相关,和血小板负相关,即重症感染越危重,则降钙素原、C-反应蛋白越高,而血小板则越低(P<0.05).结论 重症感染病情危重程度和血清降钙素原、C-反应蛋白、血小板计数有相关性,结合APACHEⅡ评分可作为重要参考指标.%Objective To investigate the correlation between severity of the disease and the serum levels of calcitonin,C reactive protein and platelet count in patients with severe infection so as to reduce infection rate and infection degree.Methods The clinical data about 56 patients with severe infections who were treated in our hospital from June 2012 to October 2015 were retrospectively analyzed,and the 56 patients were served as observation group,in whom 13 patients were died (death case group),and the disease condition in the other 43 patients was improved (improvement group),meanwhile,52 patients with upper respiratory tract infection were served as control group.The changes of serum procalcitonin,C reactive protein and platelet count in different groups and in different time pionts were observed,and the APACHE score was regarded as infection degree and the correlation among the three indexes mentioned above.Results The levels of serum procalcitonin and C reactive protein in observation group were significantly higher than those in control group,however,platelet count in observation group was significantly lower than that in control group (P<0.05).On the first day after hospitalization,there were no significant differences in C reactive protein and platelet count between death case group and improvement group (P>0.05),however,the levels of serum procalcitonin in improvement group were significantly lower than those in death case group (P<0.05).On the third day and seventh day after hospitalization,the levels of serum procalcitonin and C reactive protein in death case group were significantly higher than those in improvement group,however,the platelet count in death case group was significantly lower than that in improvement group (P<0.05).The infection severity was positively correlated to procalcitonin and C reactive protein,however,which was negatively correlated with platelet (P<0.05).Conclusion The severity of severe infection is correlated with serum levels of calcitonin,C reactive protein and platelet count,and these indexes combined with APACHE Ⅱ score can be regarded as important reference indexes.