摘要
目的：研究动脉血气分析、血乳酸、D-二聚体、C反应蛋白、降钙素原的动态监测对感染性休克患者疾病严重程度及预后的判断。方法测定55例感染性休克患者入院第1，2，3，4天以及好转出院前或死亡前患者动脉血气分析PH值、PaO2、SaO2、BE、HCO3-、血乳酸、D-二聚体、C反应蛋白、降钙素原，按预后将患者分为治愈组（38例）、非治愈组（17例）进行各项指标的动态监测，并对动态变化进行相应的分析。结果感染性休克患者非治愈组与治愈组入组第1天动脉血气分析PH值、PaO2、SaO2、BE、HCO3-、血乳酸、D-二聚体、C反应蛋白、降钙素原各项指标比较均无统计学意义，非治愈组第2，3，4及最后一次检测动脉血气分析PH值、PaO2、SaO2、BE、HCO3-的均值明显低于治愈组，而血乳酸、D-二聚体、C反应蛋白、降钙素原的均值明显高于治愈组。结论血气分析PH值、PaO2、SaO2、BE、HCO3-持续低水平，血乳酸、D-二聚体、C反应蛋白、降钙素原持续高水平提示病情危重，预后差，故动态监测血气分析、血乳酸、D-二聚体、C反应蛋白、降钙素原是评估感染性休克预后的良好指标。
Objective To study the correlation between the dynamic changes of certain indicators （arterial blood gas analysis, blood lactate, D-dimer, C-reactive protein, procalcitonin） and the severity and prognosis of patients with septic shock. Methods 55 cases of hospitalized patients with septic shock were monitored for their respective arterial blood gas analysis, D2 dimer, C-reactive protein and procalcitonin on the 1st, 2nd, 3rd, and 4th day after admission, and before being dead or discharged, and the results were analyzed. Based on the prognosis, the patients were divided into healing group of 38 cases, and non-healing group of 17 cases. A dynamic monitoring on their respective indicators was conducted and analyzed. Results No statistical difference was found in between the two groups on arterial blood gas analysis, D2 dimer, C-reactive protein and procalcitonin at the first day after admission. The PH value, PaO2, SaO2, BE and HCO3- of non-healing group at 2nd, 3rd, and 4th day and the last test were significantly lower than the healing group. Nevertheless the blood lactate, D2 dimer, C-reactive protein, and procalcitonin of non-healing group were significantly higher than the healing group. Conclusion Sustained low levels of PH value of blood gas analysis, PaO2, SaO2, BE, HCO3- and sustained high levels of D2 dimer, blood lactate, C-reactive protein, procalcitonin indicate a critical condition with a poor prognosis. So the blood gas analysis, blood lactate, D2 dimer, C-reactive protein and procalcitonin were considered as being valid indicators to assess the prognosis for the patients with septic shock.
出处
《中国急救复苏与灾害医学杂志》
2015年第3期216-218,共3页
China Journal of Emergency Resuscitation and Disaster Medicine
