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《天津医科大学学报》[ISSN:1006-8147/CN:12-1259/R]

卷:

24卷

期数:

2018年06期

页码:

529-531

栏目:

临床医学

出版日期:

2018-11-20

文章信息/Info

Title:

Clinical significance of serum PCT clearance for the prognosis of patients with sepsis caused by pulmonary infection

作者:

王海宾;  徐 磊

（天津医科大学第三中心临床学院ICU，天津 300170）

Author(s):

WANG Hai-bin;  XU Lei

（Department of ICU, The Third Clinical Hospital , Tianjin Medical University, Tianjin 300170, China）

关键词:

降钙素原清除率;  ICU;  脓毒症;  预后

Keywords:

PCT clearance;  ICU;  sepsis;  prognosis

分类号:

R631

DOI:

-

文献标志码:

A

摘要:

目的：探讨血降钙素原（PCT）清除率对肺部感染导致的脓毒症患者预后的临床意义。方法：选取我院ICU收治的因肺部感染导致脓毒症者123例，所有患者均于入院后的0、24、48、72 h采用免疫荧光法测定外周血标本PCT，根据统计数据结果计算入院后第24、48、72 h的PCT清除率。根据患者出ICU时状态分为生存组和死亡组。通过分析PCT和PCT清除率之间的差异性，绘制ROC曲线，分析PCT清除率对预后的评估能力。结果：74例患者经治疗后好转（生存组），占60.2%，49例死亡(死亡组），占39.8 %。两组之间0、24 h PCT无统计学差异（P>0.05），48、72 h生存组低于死亡组，有显著统计学差异（P<0.01）。生存组与死亡组相比， PCT清除率24、48、72 h PCT清除率均高于死亡组，有显著统计学差异（P<0.01）。72 h PCT清除率ROC曲线下面积为0.779（0.688~0.87），可以作为预后判断指标。结论：在肺部感染导致的脓毒症患者死亡率与PCT水平升高有关，且72 h PCT清除率对预后评估有明显的价值。

Abstract:

Objective: To investigate the clinical significance of serum procalcitonin (PCT) clearance rate in the prognosis of patients with sepsis caused by pulmonary infection. Methods: One hundred and twenty-four patients of sepsis caused by pulmonary infection were divided into two groups: survival group(74 patients) and death group(49 patients).The serum PCT levels were measured at 0, 24 h, 48 h and 72 h after admission to the ICU, then the PCT clearance of the 24 h , 48 h and 72 h were calculated. The serum PCT levels and PCT clearance were compared between two groups and the ROC curve for predicting the prognosis of PCT clearance were analyzed. Results: PCT clearance was higher in the survival group than that in death group, with significant difference：24h[47.825（19.9-54.04）vs 8.24（-41.05-36.21）], 48 h [72.88（53.25-77.79）vs16.8（-79.31-41.33）] and 72 h [78.765（68.37-83.98）vs 28.73（-46.05-53.22）].The area under the ROC curve of the 72 h PCT clearance was 0.779 (95% CI, 0.688-0.87, P＜0.001）. Conclusion: The mortality of patients with sepsis caused by pulmonary infection is related to the PCT level increase, and the 72 h PCT clearance has significantly value for prognosis evaluation.

参考文献/References:

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相似文献/References:

[1]丁 娜 综 述,刘娜娜 审 校.ICU患者应激性心肌病的研究进展[J].天津医科大学学报,2018,24(05):466.

备注/Memo

备注/Memo:

作者简介 王海宾（1978-），男，主治医师，硕士在读，研究方向：急症医学；通信作者：徐磊， E-mail:nokia007008@163.com。

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更新日期/Last Update: 2018-11-30