Objective To investigate the value of lactic acid, pro - calcitonin and D - dimer in estimating the prognosis of sepsis patients. Methods Forty - eight patients diagnosed with sepsis were divided into two groups: survival group and death group based on their outcomes. Levels of lactic acid, pro - calcitonin and D - dimer were detected in the early stage of medical treatment, as well as APACHE Ⅱ scores and clearances of lactic acid and pro - calcitonin. ROC was draw to observe the predicting value of these three parameters on prognosis. And to observe the death differences of patients between combined three kinds of indexes teams ( the united group ) and the nonassociation group. Results Significant differences were found in these three biomarker levels and APACH E Ⅱ scores between two groups ( P < 0. 05 ). The region of area of three parameters was from 0.71 -0.82. The 6 h and 24 h clearance rate of lactic acid, the 24 h and 72 h clearance rate of pro - calcitonin of the patients from the survival group were significantly higher than those from the death group ( P <0.05 ). Significant differences were demonstrated in the death between the united group and the nonassociation group( Pearson chi square test:χ2=4.090, P =0.043 ). Conclusion Combination of lactic acid, pro - calcitonin and D - dimer is more sensitive than one of these parameters alone in estimating sepsis patients'prognosis.%目的 探讨联合运用乳酸、降钙素原和D-二聚体水平变化评价脓毒症患者预后的价值.方法 48例住院脓毒症患者按照预后分为存活组和死亡组,对比两组患者病程早期乳酸、降钙素原、D-二聚体水平、慢性健康状况评分(APACHE Ⅱ)以及乳酸和降钙素原清除率,同时通过ROC曲线观察不同指标对预后的参考价值,并观察联合三种指标组(联合组)与非联合组间患者病死人数的差异.结果 两组患者在三种指标和APACHEⅡ评分均存在统计学差异(P<0.05).三种指标预测死亡结局的ROC曲线下面积在0.71～0.82.存活组患者6 h和24 h乳酸清除率,24 h和72 h降钙素原清除率均显著高于死亡组患者(P<0.05).联合组与非联合组间患者死亡人数差异有统计学意义(χ2=4.090,P=0.043).结论 联合乳酸、降钙素原和D-二聚体检测对于预测脓毒症患者结局灵敏性高于非联合组.
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