Objective To explore whether SIRS happened in patients with hepatic failure,and whether SIRS score and procalcitonin (PCT) can predict infection. Methods Retrospective analysis of 104 patients with hepatic failure admitted in the intensive care unit (ICU) from September 2009 to January 2011. Patients were divided into two groups: infection group and non-infection group. SIRS scores and the level of PCT of two groups were compared. Results SIRS score in 91.7% of patients was greater than or equal to 1. The differences of tempreture, heart rate, respiratory rate and distribution of SIRS scores were not significant between two groups (P ＞ 0.05), but the differences of white blood count and PCT level were significant between two groups (P ＜ 0.05). Conclusions Patients with hepatic failure will easily concurrent SIRS or infection. SIRS score can not predict infection, but monitoring the WBC and PCT, with imaging and the bacterial/fungal culture can help diagnosis infection, and then reasonable and effective treatment may be selected.%探讨肝衰竭患者发生全身炎症反应综合征(SIRS)的情况,以及SIRS评分、血清降钙素原(PCT)对并发感染的早期诊断价值.方法:回顾性分析2009年9月至2011年1月我院ICU 104例肝衰竭患者的临床资料,依据有无并发感染分为感染组和非感染组,收集临床资料后进行SIRS评分,比较两组患者SIRS评分和血清PCT水平.结果:91.7％的患者SIRS评分≥1分,非感染组与感染组体温、心率、呼吸频率等生命征之间的差异不显著(P＞0.05),而血WBC计数差异显著(P＜0.05);非感染组与感染组SIRS评分分布差异不显著(P＞ 0.05);62.30％的重肝患者PCT值为临界指标(0.5 ～1 ng/mL),非感染组与感染组PCT水平差异显著(P＜0.05).结论:肝衰竭患者常并发SIRS,也容易合并感染,患者的SIRS评分并不能早期灵敏地提示感染发生.应积极监测血WBC计数、PCT等变化,结合影像学检查早期发现感染,并通过血培养及怀疑感染部位的分泌物、排泄物培养等以明确病原,合理有效地选用抗生素.
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