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

卷:

28卷

期数:

2022年05期

页码:

545

栏目:

临床医学

出版日期:

2022-09-20

文章信息/Info

Title:

Prognosis value of procalcitonin，D-dimer combined with SOFA scores in sepsis

文章编号:

1006-8147(2022)05-0545-05

作者:

邓亚涛; 岳俊学; 吴建峰; 陈香涛

（济源市人民医院急诊科，济源459003）

Author(s):

DENG Ya-tao; YUE Jun-xue; WU Jian-feng; CHEN Xiang-tao

（Department of Emergency，Jiyuan People′s Hospital，Jiyuan 459003，China）

关键词:

降钙素原; D-二聚体; SOFA评分; 脓毒症; 预后

Keywords:

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

分类号:

R631

DOI:

-

文献标志码:

A

摘要:

目的：探讨降钙素原、D-二聚体联合SOFA评分对脓毒症患者预后的评估价值。方法：通过回顾性分析，选择2017年10月—2020年10月在济源市人民医院诊治的脓毒症患者60例，根据患者入院28 d预后情况将其分为存活组（43例）和死亡组（17例）。对比存活组和死亡组的一般临床资料信息，记录患者入院24 h内的降钙素原、D-二聚体、SOFA评分、白细胞、血小板等实验室指标及28 d预后；通过多因素Logisitic回归分析影响脓毒症患者预后的独立危险因素；建立降钙素原、D-二聚体和SOFA评分的组合，分析降钙素原、D-二聚体联合SOFA评分对脓毒症患者预后的评估价值。结果：存活组降钙素原、D-二聚体水平和SOFA评分明显低于死亡组（t=22.720、17.640、2.327），有血液系统疾病史的病例数也低于死亡组（χ2=4.596）;血小板水平明显高于死亡组（t=7.904），差异均具有统计学意义（均P<0.05）。多因素Logistic回归分析结果表明，降钙素原（OR=1.311，95%CI：1.024～1.874）、D-二聚体水平（OR=1.809，95%CI：1.204～2.377）和SOFA评分（OR=1.358，95%CI：1.129～1.886；P<0.05）是评价脓毒症患者预后的独立危险因素。降钙素原、D-二聚体联合SOFA评分对脓毒症患者预后的曲线下面积（0.981）大于单独使用降钙素原（0.875）、D-二聚体（0.807）和SOFA评分（0.823）的面积，且降钙素原、D-二聚体联合SOFA评分的灵敏度和特异性分别为92.7%和98.1%，也高于单独使用单一指标。结论：降钙素原、D-二聚体水平和SOFA评分是评价脓毒症患者预后的独立危险因素，三者联合应用比单一使用更有效，具有更高的临床预估价值。

Abstract:

Objective： To evaluate the prognostic value of procalcitonin，D-dimer combined with sequential organ failureassessment （SOFA） Scores in patients with sepsis. Methods：Through retrospective analysis，60 patients with sepsis diagnosed and treated in Jiyuan People′s Hospital from October 2017 to October 2020 were selected for this study，and they were divided into survival group（43 cases） and death group（17 cases） according to the prognosis of 28 d after admission. The general clinical data of the survival group and the death group were compared，and the laboratory indicators of procalcitonin，D-dimer，SOFA scores，white blood cells，platelets and prognosis at 28 days were recorded within 24 h after admission. Multivariate Logisitic regression was used to analyze the independent risk factors affecting the prognosis of sepsis patients. The combination of procalcitonin，D-dimer and SOFA scores was established to analyze the prognostic value of procalcitonin，D-dimer and SOFA scores in patients with sepsis. Results：The levels of procalcitonin，D-dimer and SOFA scores in the survival group were significantly lower than those in the death group（t=22.720，17.640，2.327），and the number of cases with a history of blood system diseases was also lower than that in the death group（χ2=4.596）， the platelet level in the survival group was significantly higher than that in the death group（t=7.904），with statistical significance（all P<0.05）. Multivariate Logistic regression analysis showed that procalcitonin（OR=1.311，95%CI:1.024-1.874），D-dimer levels（OR=1.809，95%CI：1.204-2.377）and SOFA scores（OR=1.358，95%CI:1.129-1.886） were independent risk factors for the prognosis of sepsis patients. The area under the curve of procalcitonin，D-dimer combined with SOFA scores for the prognosis of sepsis patients was 0.981 larger than that of procalcitonin alone（0.875），D-dimer alone（0.807） and SOFA scores（0.823），and the sensitivity and specificity of procalcitonin，D-dimer combined with SOFA scores were 92.7% and 98.1%，respectively，which were higher than those individual indicators. Conclusion：Procalcitonin and D-dimer levels，and the SOFA scores are independent risk factors for the prognosis of patients with sepsis，and the combination of the three is more effective than the single use，with higher clinical predictive value.

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备注/Memo

备注/Memo:

作者简介 邓亚涛（1983-），男，主治医师，学士，研究方向：临床重症医学；通信作者：岳俊学，E-mail：m18813116121@163.com。

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更新日期/Last Update: 2022-09-20