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

卷:

27卷

期数:

2021年04期

页码:

360-364

栏目:

临床医学

出版日期:

2021-07-20

文章信息/Info

Title:

Prognostic value of procalcitonin and D-dimer combined with SOFA scores in sepsis

文章编号:

1006－8147（2021）04-0360-05

作者:

崔航; 夏璠; 何新飙

（天津医科大学第二医院ICU，天津 300211）

Author(s):

CUI Hang; XIA Fan; HE Xin-biao

（Department of ICU，The Second Hospital，Tianjin Medical University ，Tianjin 300211，China）

关键词:

脓毒症; 降钙素原; D-二聚体; SOFA评分; 预后

Keywords:

sepsis; procalcitonin; D-dimer; SOFA scores; prognosis

分类号:

R631

DOI:

-

文献标志码:

A

摘要:

目的：探讨降钙素原（PCT）、D-二聚体（D-dimer，D-D）联合序贯器官衰竭估计评分（SOFA评分）对脓毒症患者预后的评估价值。方法：回顾性分析2018年10月—2020年5月在重症监护病房（ICU）治疗的100例脓毒症患者的相关临床数据，按28 d预后将患者分为生存组和死亡组，比较两组PCT、D-D、SOFA评分差异，通过Logistic回归分析确认影响脓毒症患者预后的独立危险因素，建立PCT、D-D和SOFA评分的组合，绘制受试者工作特征（ROC）曲线，分析PCT、D-D联合SOFA评分对脓毒症患者预后的评估价值。结果：（1）死亡组的PCT（Z=-5.473，P<0.05）、D-D（Z=-4.454，P<0.05）和SOFA评分（Z=-4.859，P<0.05）均明显高于生存组，差异有统计学意义。（2）Logistic回归分析显示PCT（OR=1.284，95%CI：1.099～1.500）、D-D（OR=1.552，95%CI:1.130～2.131）及SOFA评分（OR=1.458，95%CI：1.157～1.837）是影响脓毒症患者预后的独立危险因素（均P<0.05）。（3）PCT、D-D联合SOFA评分评估脓毒症28 d预后的曲线下面积（AUC）0.957大于单独使用PCT、D-D和SOFA评分的面积（0.883、0.811、0.838），且PCT、D-D联合SOFA评分的灵敏度及特异度分别为90.9%和84.6%，也较单独指标有所提高。结论：PCT、D-D和SOFA评分是影响脓毒症患者预后的独立危险因素；PCT、D-D联合SOFA评分评估脓毒症患者预后的能力大于单一指标。

Abstract:

Objective: To evaluate the prognostic value of procalcitonin（PCT） and D-dimer（D-D） combined with sequential organ failure assessment（SOFA） scores in patients with sepsis. Methods: The clinical data of 100 patients with sepsis who were treated in the ICU during the period of October 2018 to May 2020 were retrospectively analyzed. The patients were divided into survival group and death group according to the prognosis of 28 d. The differences of PCT，D-D and SOFA scores between the two groups were compared，the independent risk factors affecting prognosis of patients with sepsis were confirmed by Logistic regression analysis，the combination of PCT，D-D and SOFA score was established，and the receiver operating characteristic（ROC） curve was drawn.The prognostic value of PCT，D-D combined with SOFA score in patients with sepsis was analyzed. Results：（1）The PCT（Z=-5.473，P<0.05），D-D（Z=-4.454，P<0.05） and SFOA scores（Z=-4.859，P<0.05） in death group were significantly higher than that in survival group，the difference was statistically significant. （2）Logistic regression analysis showed that PCT（OR=1.284，95%CI: 1.099-1.500），D-D（OR=1.552，95%CI:1.130-2.131） and SOFA scores （OR=1.458，95%CI:1.157-1.837） were independent risk factors for prognosis of patients with sepsis（all P<0.05）.（3）The area under the curve（AUC） of the 28 d prognosis of sepsis assessed by PCT，D-D combined with SOFA scores（0.957） was larger than that of AUC（0.883，0.811，0.838） using PCT，D-D and SOFA scores alone. The sensitivity and specificity of PCT，D-D combined with SOFA scores were 90.9% and 84.6% respectively，which were higher than those individual indicators. Conclusion: PCT，D-D and SOFA scores are independent risk factors for prognosis of patients with sepsis，and PCT，D-D combined SOFA scores is more effective than single index in evaluating prognosis of patients with sepsis.

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备注/Memo

备注/Memo:

基金项目：天津市自然科学基金（09JCYBJC11300）
作者简介：崔航(1994-)，男，硕士在读，研究方向：急诊医学；通信作者：何新飙，E-mail:hexinbiaoqz@163.com。

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更新日期/Last Update: 2021-07-25