摘要
目的分析SOFA评分联合血清降钙素原(PCT)对脓毒症早期诊断及评估预后的效果。方法将ICU住院的107例危重病患者根据病情分为SIRS组31例、轻度脓毒症组26例、严重脓毒症组25例、脓毒性休克组25例,并选择同期健康体检患者30例;同时根据脓毒症患者预后分为存活组39例和死亡组68例,比较分析各组患者血清PCT、C反应蛋白(CRP)水平及SOFA评分的变化。结果血清PCT、CRP、SOFA评分在SIRS组(1.76±0.36)μg/L、(53.42±12.44)mg/L、(3.54±1.24)分,轻度脓毒症(2.25±0.74)μg/L、(87.25±13.27)mg/L、(6.75±2.37)分,严重脓毒症组(5.54±1.43)μg/L、(91.73±16.63)mg/L、(8.49±2.83)分,脓毒性休克组(8.82±2.54)μg/L、(112.74±23.57)mg/L、(10.26±3.37)分,均较对照组明显升高,且随着病情的加重,患者血清PCT、SOFA评分依次增加(P<0.05);3组脓毒症患者血清PCT、CRP、SOFA评分较SIRS组显著升高,而各组脓毒症患者的CRP水平比较,差异无统计学意义;死亡组血清PCT、SOFA评分(7.63±2.68)μg/L、(9.06±2.26)分较存活组的(2.37±1.03)μg/L、(5.38±1.87)分显著升高(P<0.05),而两组CRP水平比较,差异无统计学意义;logistic回归分析结果显示,血清PCT、SOFA评分是脓毒症患者发生的独立危险因素(OR=5.132,7.369,P<0.05)。结论血清PCT、SOFA评分可作为脓毒症的早期诊断指标,SOFA评分联合PCT水平的检测对评估脓毒症病情严重程度及预后的具有重要意义。
OBJECTIVE To explore the value of serum procalcitonin （PCT） and SOFA score in the early diagnosis and prognosis of sepsis. METHODS According to the severity of disease, 107 patients of critical illness patients who were admitted in ICU were divided into four groups, including 31 patients of the SIRS group, 26 patients of the sepsis group, 25 patients of the severe sepsis group, and 25 patients of the septic shock group, and at the same time 30 healthy people were selected and were also divided into the survivor group and the death group according to the prognosis. The levels of serum PCT , CRP ,and the SOFA scores were detected and compared. RESULTS The level of the serum PCT, CRP and the SOFA scores were respectively （1.76±0.36） μg/L, （53.42±12.44） mg/ L,and （3.54±1.24） points in the SIRS group, （2.25±0.74） μg/L, （87. 254±13.27） mg/L,and （6. 754±2.37） points in the mile sepsis group, （5.54±1.43） μg/L, （91.73±16. 63） mg/L,and （8. 49±2. 83） in the severe sepsis group, and （8.82±2.54） μg/L, （112. 74±23.57） mg/L,and （10. 26±3. 37） points in the septic shock group, which were significantly increased as compared with the control group, and with the severity aggravating, the serum PCT and the SOFA scores were increased separately （P〈0.05）. The levels of serum PCT, CRP and the SOFA scores of the three sepsis groups were significantly higher than those of the SIRS group, while the difference in the level of CRP among the three sepsis groups was not statistically significant. The serum PCT level and the SOFA score of the death group were respectively （7.63±2.68） μg/L and （9. 065=2.26） points, signifi-cantly higher than （2. 37±1.03） μg/L and （5. 38±1.87） points of the survivor group （P〈0.05）, however,the difference in the level of CRP between the two groups was not statistically significant ; the logistic regression a-nalysis indicated that the serum PCT level and the SOFA score were the independent risk factors of the sepsis （OR=5. 132, 7. 369, P〈0.05）. CONCLUSION The serum PCT levels and the SOFA score can be served as an early diagnosis indicator of sepsis, and it is of great significance in the evaluation of severity and prognosis of the pa-tients with sepsis through the SOFA score combined with the detection of PCT level.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2013年第11期2536-2538,共3页
Chinese Journal of Nosocomiology
