摘要
目的研究血清降钙素原(PCT)动态变化及乳酸清除率对脓毒症患者预后评估的影响。方法收集2016年1月-2019年12月于广州市番禺区中心医院收治的79例脓毒症患者,根据患者预后分为死亡组(n=44)和存活组(n=35),比较两组患者血清降钙素原水平动态变化、乳酸清除率及一般资料,分析脓毒症患者预后的影响因素。结果两组患者PCT水平在入院0 h、入院后72 h及入院后96 h比较差异无统计学意义(P>0.05);死亡组患者入院后120 h PCT水平明显高于存活组,120 h PCT清除率明显低于存活组,差异均有统计学意义(t=52.349、10.806,P<0.05);死亡组患者入院0 h、入院后6 h乳酸水平明显高于存活组,乳酸清除率明显低于存活组,差异均有统计学意义(t=6.151、11.606、33.463,P<0.05)。两组患者在性别、合并基础疾病、感染部位、年龄及白细胞计数(WBC)水平比较差异无统计学意义(P>0.05);死亡组序贯器官衰竭评分(SOFA)及C反应蛋白(CRP)水平明显高于存活组,差异均有统计学意义(t=8.810、17.759,P<0.05)。Logistic回归分析显示,SOFA评分、乳酸清除率、120 h PCT清除率及CRP是脓毒症患者预后的影响因素,差异均有统计学意义(P<0.05)。结论脓毒症患者监测SOFA评分、6 h乳酸清除率、120 h PCT清除率可有效预测患者预后情况。
Objective To evaluate the treatment prognosis and influence factors of sepsis patients through serum procalcitonin(PCT)changes and lactate clearance rate.Methods 79 sepsis patients treated from January 2016 to December 2019 in Guangzhou Panyu Central Hospital were selected as research subjects.According to prognosis conditions,patients were divided into death group(n=44)and survival group(n=35).The dynamic changes of serum procalcitonin level,lactate clearance rate and general information of the two groups were compared,the prognostic factors of patients with sepsis were analyzed through ogistic regression analysis.Results After 0,72 and 96 h of admission,PCT levels between the two groups were not significantly different(P>0.05);after 120 h of admission,PCT level in death group were significantly higher than that of survival group;120 h PCT clearance rate was significantly lower than that of survival group(t=52.349,10.806,P<0.05);after 0 and 6 h of admission,lactate levels in death group were higher than those of survival group;lactate clearance rate was lower than that of survival group(t=6.151,11.606,33.463,P<0.05).Gender,complication of underlying diseases,infection positions,age and white blood cell(WBC)between the two groups were not significantly different(P>0.05).Sequential organ failure assessment(SOFA)scores and C-reactive protein(CRP)in death group were significantly higher than those of survival group(t=8.810,17.759,P<0.05).According to logistic regression analysis,it was known that the influence factors of prognosis included SOFA scores,lactate clearance rate,120 h PCT clearance rate and CRP(P<0.05).Conclusion The monitoring of SOFA scores,6 h lactate clearance rate,120 h PCT clearance rate could evaluate the prognosis of sepsis patients.
作者
明月
何金花
陈瑾
吴文斌
MING Yue;HE Jin-hua;CHEN Jin;WU Wen-bing(Infectious Department of Guangzhou Panyu Central Hospital,Guangzhou,Guangdong 511400,China)
出处
《热带医学杂志》
CAS
2022年第3期359-362,共4页
Journal of Tropical Medicine
基金
广东省医学科研基金(A2020304)
关键词
血清降钙素原
乳酸清除率
脓毒症
影响因素
Serum procalcitonin
Lactate clearance rate
Sepsis
Influence factors
