摘要
目的分析降钙素原(procalcitonin,PCT)动态变化水平与脓毒血症患者病情严重程度的相关性。方法选取2021年1月至2022年12月盐城市第一人民医院收治的180例脓毒血症患者作为病例组,另选取本院同期50名健康体检者作为对照组。按病情严重程度将病例组分为脓毒症组(n=102)、严重脓毒症组(n=52)及脓毒性休克组(n=26),根据治疗28 d后不同预后情况,将病例组分为存活组与死亡组,比较病例组与对照组、病例组不同病情严重程度亚组及不同预后组PCT水平、PCT清除率(PCT clearance rate,PCTc)、皮质醇(cortisol,Cor)水平及急性生理学及慢性健康状况评分系统Ⅱ(acute physiology and chronic health evaluation scoring system,APACHEⅡ)评分、序贯器官功能衰竭评估(sequential organ failure assessment,SOFA)评分,并分析PCT、PCTc与Cor水平、APACHEⅡ及SOFA评分的相关性。结果病例组血清PCT水平、Cor水平及APACHEⅡ评分、SOFA评分均高于对照组,差异有统计学意义(P<0.05)。病例组中3组不同病情严重程度亚组血清PCT水平、PCTc、Cor水平及APACHEⅡ评分、SOFA评分比较差异有统计学意义(P<0.05),其中,脓毒症休克组血清PCT水平、Cor水平及APACHEⅡ评分、SOFA评分高于严重脓毒症组、脓毒症组,且严重脓毒症组高于脓毒症组,差异有统计学意义(P<0.05);脓毒症休克组PCTc低于严重脓毒症组、脓毒症组,且严重脓毒症组低于脓毒症组,差异有统计学意义(P<0.05)。治疗28 d后,存活152例,死亡28例;死亡组血清PCT、Cor水平及APACHEⅡ评分、SOFA评分高于存活组,PCTc低于存活组,差异有统计学意义(P<0.05)。Spearman相关分析显示,血清PCT水平与Cor水平、APACHEⅡ评分、SOFA评分均呈正相关(r>0,P<0.05),PCTc与上述指标呈负相关(r<0,P<0.05)。结论血清PCT水平随着脓毒症患者病情程度的加重而升高,其可判定脓毒血症患者病情程度及预后,应用价值较高。
Objective To analyze the correlation between the dynamic change level of procalcitonin(PCT)and the severity of sepsis.Methods A total of 180 patients with sepsis admitted to Yancheng First People's Hospital from January 2021 to December 2022 were selected as the case group,and 50 healthy physical examination subjects during the same period in our hospital were selected as the control group.The patients in the case group were divided into the sepsis group(n=102),severe sepsis group(n=52)and the septic shock group(n=26)according to the severity of the disease.According to the different prognosis after 28 d of treatment,the patients with sepsis were divided into the survival group and the death group.PCT level,PCT clearance rate(PCTc),cortisol(Cor)level and acute physiology and chronic health evaluationⅡ(APACHEⅡ)score,sequential organ failure assessment(SOFA)score were compared between the case group and the control group,among the subgroups of different disease severity in the case group and between the different prognosis groups,and the correlation between PCT,PCTc and the Cor level,APACHEⅡscore,SOFA score were analyzed.Results Serum PCT level,Cor level,APACHEⅡscore and SOFA score in the case group were higher than those in the control group,and the differences were statistically significant(P<0.05).Serum PCT level,PCTc,Cor level,APACHEⅡscore and SOFA score were significantly different among the three subgroups of different disease severity in the case group(P<0.05);the serum PCT level,Cor level,APACHEⅡscore and SOFA score in sepsis shock group were higher than those in the severe sepsis group and sepsis group,the severe sepsis group was higher than the sepsis group,the differences were statistically significant(P<0.05);the PCTc in septic shock group was lower than that in the severe sepsis group and the sepsis group,and the severe sepsis group was lower than that in sepsis group,the difference was statistically significant(P<0.05).After 28 d of treatment,152 cases were survived and 28 cases were died;the levels of serum PCT,Cor,APACHEⅡscore and SOFA score in the death group were higher than those in the survival group,and PCTc was lower than those in the survival group,the differences were statistically significant(P<0.05).Spearman correlation analysis showed that serum PCT level was positively correlated with Cor level,APACHEⅡscore and SOFA score(r>0,P<0.05),while PCTc was negatively correlated with the above indexes(r<0,P<0.05).Conclusion Serum PCT level increases with the severity of sepsis,which can determine the severity and prognosis of sepsis patients,and has high application value.
作者
孙杨
胥亚
高雯
SUN Yang;XU Ya;GAO Wen(Department of Clinical Laboratory,Yancheng First People's Hospital,Yancheng,Jiangsu,224000,China)
出处
《当代医学》
2025年第4期97-101,共5页
Contemporary Medicine
