摘要
目的探讨C-反应蛋白及降钙素原在创伤后脓毒血症中的动态变化及对预后的评估价值。方法选择诸暨市中心医院创伤后脓毒血症患者78例作为研究对象,比较脓毒血症组与对照组之间血清CRP及PCT水平的差异。根据脓毒血症的不同程度将入选的创伤后脓毒血症病例分为单纯脓毒血症、脓毒血症合并器官功能衰竭及感染性休克组,比较三组患者血清CRP水平、血清PCT水平及APACHE-Ⅱ评分的差异。根据不同的随访结果将脓毒血症患者分为好转、无效及病死组,比较三组入选当日、入选后第3、5天血清CRP及PCT水平的变化。结果入选当日,脓毒血症组患者血清CRP及PCT水平均明显高于对照组,差异具有统计学意义(t=68.472、40.243,P<0.01)。不同程度脓毒血症组患者血清CRP、PCT水平及APACHE-Ⅱ评分均不完全相同(F=3.804、8.292、5.273,P<0.05),单纯脓毒血症及脓毒血症合并器官功能衰竭组在血清CRP水平上差异无统计学意义(P>0.05),其余两组间比较差异均有统计学意义(P<0.05);脓毒血症患者中,好转组入选后第5天血清CRP水平较入选当日及第3天降低(P<0.05),但入选当日及第3天CRP水平差异无统计学意义(P>0.05);血清PCT水平入选当日、入选后第3天、第5天呈逐渐下降趋势,组间比较差异均有统计学意义(P<0.05)。病死组患者血清CRP水平入选当日、入选后第3天、第5天均差异无统计学意义(P>0.05),而血清PCT水平呈递增趋势,组间比较差异均有统计学意义(P<0.05)。无效组血清CRP及PCT水平入选当日、入选后第3天、第5天差异均无统计学意义(P>0.05)。结论血清CRP及PCT水平均能反应创伤后脓毒血症的感染状态,但在评估病情及预后方面,血清PCT更具有优势。
Objective To explore the dynamic change of C-reactive protein （CRP） and procalcitonin （PCT） in sepsis after trauma and its value for the assessment of prognosis. Methods 78 patients with sepsis after trauma were divided into the Simple sepsis group, Sepsis ＆ organ failure group, or Septic shock group depending on the severity of sepsis. The levels of CRP and PCT as well as the score of APACHE-II were compared and analyzed among three groups. Then the patients were divided into the Response group, Non response group or Death group according to their outcomes; the CRR and PCT at Day 1, Day 3 and Day 5 were compared. Results The levels of CRP and PCT at Day 1 （Enrollment day） in the Simple sepsis group were significantly higher than in the control group （t=68.472,40.243, P〈0.01）. The levels of CRP and PCT and the score of APACHE-II were not identical between groups （F=3.804, 8.292, 5.273, P〈0.05）; the difference in the level of CRP was significant （P〈0.05） but not between Simple sepsis group and Sepsis ＆ organ failure group （P〉0.05）. The level of CRP in Response group at Day 5 was lower than at Day 1 and Day 3, but there was not significant difference between that at Day 1 and Day 3 （P〉0.05）. The level of PCT gradually decreased from Day 1 and Day 3 to Day 5 （P〈0.05）. The level of CRP in Death group did not change significantly （P〉0.05）, but that of PCT gradually increased （P〈0.05）. There were no significant differences in the levels of CRP and PCT in Non response group at the three time points （P〉0.05）. Conclusion The levels of CRP and PCT can reflect the infection status of patients with sepsis after trauma, but that of PCT is better for the assessment of the severity and prognosis.
作者
何琦丽
HE Qili(Department of Endocrinology, Central Hospital of Zhuji, Zhuji, Zhejiang 313300, China)
出处
《中国微生态学杂志》
CAS
CSCD
2017年第6期704-706,711,共4页
Chinese Journal of Microecology
