降钙素原与超敏C-反应蛋白和N末端前体脑钠肽对脓毒症预后的评估价值

发布时间：2017-12-28 13:40

本文关键词：降钙素原与超敏C-反应蛋白和N末端前体脑钠肽对脓毒症预后的评估价值　出处：《中华医院感染学杂志》2016年10期 　论文类型：期刊论文

【摘要】：目的探讨血清降钙素原(PCT)、超敏C-反应蛋白(hs-CRP)和N末端前体脑钠肽(NT-proBNP)对脓毒血症预后评估的价值,为临床诊断、治疗提供参考。方法选取医院2012年1月-2015年1月入住ICU的脓毒血症患者81例为研究对象,按照预后情况将患者分为死亡组35例和存活组46例,比较两组患者发病早期PCT、hs-CRP、NT-proBNP及急性生理与慢性健康状况(APACHEⅡ)评分,并通过ROC曲线观察3种指标对预后评估的参考价值;采用SPSS20.0软件进行统计分析。结果两组患者PCT、hs-CRP、NT-proBNP和APACHEⅡ评分差异均有统计学意义(P0.05),同时PCT、hs-CRP、NT-proBNP指标水平与APACHEⅡ评分存在明显相关(P0.05);PCT、hs-CRP、NT-proBNP和APACHEⅡ评分预测死亡的受试者工作特征曲线(ROC)下面积分别为0.812、0.543、0.856和0.858,PCT的敏感性和特异性为79.5%和77.4%,hs-CRP的敏感性和特异性为69.3%和70.0%,NT-proBNP敏感性和特异性为80.1%和83.3%,APACHEⅡ评分敏感性和特异性为96.1%和80.5%,APACHEⅡ评分诊断价值最高,PCT和NT-proBNP对脓毒血症预后的评估优于hs-CRP。结论 NT-proBNP和PCT对脓毒血症患者具有较高的预后评估价值,准确的判断脓毒症患者的预后,可以降低脓毒血症患者的病死率。
[Abstract]:Objective to investigate the prognostic value of serum procalcitonin (PCT), high sensitivity C- reactive protein (hs-CRP) and N terminal pro brain natriuretic peptide (NT-proBNP) in sepsis, so as to provide references for clinical diagnosis and treatment. Methods the hospital in January 2012 January -2015 in ICU of patients with sepsis and 81 cases as the research object, according to prognosis, patients were divided into death group and survival group 35 cases of 46 cases, compared two groups of patients with early onset of PCT, hs-CRP, NT-proBNP and acute physiology and chronic health evaluation (APACHE II), and 3 kinds of index the evaluation of prognosis value were observed by ROC curve; statistical analysis by SPSS20.0 software. Results two groups of patients with PCT, hs-CRP, NT-proBNP and APACHE II score differences were statistically significant (P0.05), and PCT, hs-CRP, NT-proBNP index level and APACHE score are significantly related (P0.05); receiver operating characteristic curve of PCT, hs-CRP, NT-proBNP and APACHE II score in predicting death (ROC) area under 0.812, 0.543, 0.856 and 0.858, the sensitivity and specificity of PCT were 79.5% and 77.4%, the sensitivity and specificity of hs-CRP were 69.3% and 70%. The sensitivity and specificity of NT-proBNP was 80.1% and 83.3%, APACHE II score sensitivity and specificity of 96.1% and 80.5%, the highest score value of APACHE diagnosis, PCT and NT-proBNP on the sepsis prognosis is better than that of hs-CRP. Conclusion NT-proBNP and PCT have high prognostic value for sepsis patients. Accurate estimation of prognosis of sepsis patients can reduce the mortality of sepsis patients.
【作者单位】：新疆医科大学公共卫生学院;新疆医科大学第一附属医院医学检验中心;
【基金】：新疆维吾尔自治区医学联合基金资助项目(2015211C100)
【分类号】：R459.7
【正文快照】： 脓毒症是由各种感染引起的全身性的炎症反应综合征,是急诊科和ICU中导致患者死亡的重要原因之一[1]。脓毒症在早期的病理生理改变往往是功能性、可逆性的,所以早期监测及预测预后非常重要。既往的预后评估主要以白细胞计数及分类、C-反应蛋白(CRP)等指标作为依据,而用降钙素原

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