降钙素原、D-二聚体与乳酸对脓毒血症患者预后评估的临床价值研究

摘要

Objective: To investigate the value of procalcitonin, D-Dimer and lactic acid in estimating the prognosis of patients with sepsis. Methods: Fifty-six patients with sepsis were divided into survival group and death group according to their outcome. Levels of procalcitonin, D-Dimer and lactic acid were measured in the early stage of treatment, and APACHE Ⅱ were scored. ROC was constructed to observe the clinical value of the biomarkers on predicting prognosis. Results: There were significant differences in levels of 3 biomarkers and APACHE Ⅱ score between 2 groups, and all obviously correlated with APACHE Ⅱ score. The presence of more positive biomarkers,the higher the mortality were. Three biomarkers had area under the curve (AUC) around 0. 72～0. 79. Conclusions:Procalcitonin, D-Dimer and lactic acid all are good biomarkers for estimating patient's prognosis, and combined estimation can increase the sensitivity.%目的:探讨血降钙素原、D-二聚体与乳酸3种生物标记物评价脓毒血症患者预后的临床价值.方法:56例脓毒血症患者按预后分为生存组和死亡组,比较发病早期血降钙素原、D-二聚体、乳酸水平及APACHEⅡ评分,并建立ROC曲线观察标记物对预后评估的临床价值.结果:3种标记物水平和APACHEⅡ评分在2组患者均有明显差异,3种标记物水平与APACHEⅡ评分存在明显相关;标记物阳性项目越多,病死率越高;3项标记物预测死亡的ROC曲线下面积在0.72～0.79之间.结论:血降钙素原、D-二聚体和乳酸水平均对患者的死亡有较好的预测意义,联合检测可提高预测的敏感性.