摘要
目的探讨血清降钙素原(PCT)联合正五聚蛋白3(PTX3)预测脓毒症严重程度和预后的价值。方法纳入脓毒症患者100例,依据疾病严重程度分为未合并器官衰竭组56例和合并器官衰竭组44例;依据入院28 d内预后情况分为存活组81例和死亡组19例,分别比较两组患者的临床资料[包括血清PCT、PTX3水平、急性生理与慢性健康(APACHEⅡ)评分、序贯器官衰竭(SOFA)评分]。采用受试者工作特征(ROC)曲线分析各项指标预测脓毒症严重程度和预后的价值。结果合并器官衰竭组患者C反应蛋白(CRP)、氨基末端脑钠肽前体(NT-proBNP)、血乳酸、PCT、PTX3水平及APACHEⅡ评分、SOFA评分均高于未合并器官衰竭组,氧合指数低于未合并器官衰竭组(P<0.05)。ROC曲线分析结果显示,PTX3联合PCT预测脓毒症严重程度的ROC曲线下面积(AUC)为0.875,特异度为81.6%,敏感度为83.7%。死亡组患者CRP、NT-proBNP、血乳酸、PCT、PTX3水平及APACHEⅡ评分、SOFA评分均高于存活组,氧合指数低于存活组(P<0.05)。ROC曲线分析结果显示,PCT联合PTX3评估脓毒症预后的AUC为0.892,特异度为84.9%,灵敏度为87.5%。结论血清PCT联合PTX3预测脓毒症严重程度和预后的准确性及可靠性均优于APACHEⅡ评分和SOFA评分,具有一定临床价值。
Objective To explore the value of procalcitonin(PCT)combined with pentraxin 3(PTX3)in evaluating severity and prognosis of sepsis.Methods One hundred patients with sepsis were divided into without organ failure group(56 cases)and with organ failure group(44 cases)according to severity of sepsis,survival group(81 cases)and death group(19 cases)according to prognosis within 28 d of admission.Clinical data[including serum PCT,PTX3 levels,acute physiology and chronic health(APACHEⅡ)score,sequential organ failure assessment(SOFA)score]were compared between two groups respectively.Receiver operating characteristic(ROC)curve analysis was used to predict the severity and prognosis of sepsis.Results C-reactive protein(CRP),amino-terminal brain natriuretic peptide precursor(NT-proBNP),blood lactate,PCT,PTX3 levels and APACHEⅡscore,SOFA score in with organ failure group were higher than those in without organ failure group,oxygenation index was lower than that in without organ failure group(P<0.05).Results of ROC curve analysis showed that area under ROC curve(AUC)of PTX3 combined with PCT to predict the severity of sepsis was 0.875,the specificity was 0.816,and the sensitivity was 0.837.CRP,NT-proBNP,blood lactate,PCT,PTX3 levels and APACHEⅡscore,SOFA score in death group were higher than those in survival group,oxygenation index was lower than that in survival group(P<0.05).Results of ROC curve analysis showed that AUC of PTX3 combined with PCT to predict the prognosis of sepsis was 0.892,the specificity was 0.849,and the sensitivity was 0.875.Conclusion The accuracy and reliability of serum PCT combined with PTX3 in evaluating severity and prognosis of sepsis are superior to APACHEⅡscore and SOFA score,which have certain clinical value.
作者
齐三利
岳磊
朱平
Qi Sanli;Yue Lei;Zhu Ping(Department of Emergency,Luoyang Central Hospital Affiliated to Zhengzhou University,Luoyang 471009,China)
出处
《临床内科杂志》
CAS
2020年第5期346-349,共4页
Journal of Clinical Internal Medicine
