摘要
目的分析降钙素原(PCT)及D-二聚体检测对急性脓毒症患者病情及预后的预测价值。方法回顾性分析2017年2月-2019年2月本院急诊科收治的88例急性脓毒症患者的临床资料,按脓毒症的分级标准分为脓毒症组36例、重度脓毒症组25例及脓毒症休克组27例;并根据28 d内患者预后分为存活组和死亡组。分析纳入者病情程度、预后及分别与PCT和D-二聚体之间的关系。结果脓毒症休克组和重度脓毒症组28 d内病死率高于脓毒症组,且脓毒症体克组高于重度脓毒症组(P<0.01)。脓毒症休克组和重度脓毒症组PCT及D-二聚体水平高于脓毒症组,且脓毒症休克组高于重度脓毒症组(P<0.01)。死亡组PCT、D-二聚体水平高于存活组(P<0.05)。年龄>50岁、PCT>0.05 ng/ml、D-二聚体>0.3 mg/L是影响急性脓毒症患者预后的独立危险因素(P<0.01)。结论年龄、PCT、D-二聚体水平是脓毒症患者死亡的独立危险因素,可作为脓毒症诊断、治疗及预后评估的有效指标,重视PCT、D-二聚体水平检测对改善急性脓毒症患者预后有重要意义。
Objective To analyze predictive value of procalcitonin(PCT)and D-dimer detections for pathogenetic conditions and prognosis of patients with acute sepsis.Methods Clinical data of 88 patients with acute sepsis admitted during February 2017 and February 2019 was retrospectively analyzed,and the patients were divided into sepsis group(n=36),severe sepsis group(n=25)and septic shock group(n=27)according to grading criteria of sepsis.In addition,patients were divided into survival group and death group according to prognosis conditions within 28 d.Severity of the disease,prognosis and respective relationships with PCT and D-dimer were analyzed in all patients.Results The mortality of septic shock group and severe sepsis group at 20 d after treatment was high than that of sepsis group,and the mortality in septic shock group were significantly higher than that in severe sepsis group(P<0.01).PCT and D-dimer levels in septic shock and severe sepsis groups were significantly higher than those in sepsis group,and the levels in septic shock group were significantly higher than those in severe sepsis group(P<0.01).PCT and D-dimer levels in death group were significantly higher than those in survival group(P<0.05).Age>50 years,PCT>0.05 ng/ml and D-dimer level>0.3 mg/L were independent risk factors affecting the prognosis of patients with acute sepsis(P<0.01).Conclusion Age,PCT and D-dimer levels are independent risk factors of death in patients with sepsis,which may be used as effective indicators in diagnosis,treatment and prognosis evaluation for sepsis.It is helpful to pay attention to detections of PCT and D-dimer levels in improvement of prognosis of patients with acute sepsis.
作者
赵茜
李剑
李素彦
徐鑫
齐惠军
李建国
ZHAO Qian;LI Jian;LI Su-yan;XU Xin;QI Hui-jun;LI Jian-guo(Emergency Department,General Hospital of Hebei Province,Shijiazhuang 050051,China)
出处
《解放军医药杂志》
CAS
2020年第11期67-70,共4页
Medical & Pharmaceutical Journal of Chinese People’s Liberation Army
基金
河北省卫生和计划生育委员会办公室文件(20170271)。
