PCT清除率与△SOFA在复杂腹腔感染中的预测价值

发布时间：2017-12-31 21:04

本文关键词：PCT清除率与△SOFA在复杂腹腔感染中的预测价值　出处：《实用医学杂志》2016年24期 　论文类型：期刊论文

更多相关文章： 复杂腹腔感染 降钙素原 SOFA评分 预后

【摘要】：目的:探讨PCT清除率(PCT-c)与△感染相关性器官功能衰竭评分(SOFA)对复杂腹腔感染患者预后的评估价值。方法:回顾性分析2013-2015年入住重症医学科,诊断为复杂腹腔感染导致严重脓毒症及感染性休克患者65例,分为生存组和死亡组,记录诊断当天、48 h及5 d时PCT值并计算PCT-c;记录诊断当天、48 h SOFA评分,并计算48 h△SOFA。评价PCT-c与△SOFA在复杂腹腔感染中的预测价值。结果:死亡组中初始PCT值(PCT_0)较生存组高,但差异无统计学意义。生存组中PCT-c 48 h、PCT-c 5 d均高于死亡组,差异具有统计学意义(P0.05),死亡组的初始SOFA评分(SOFA_0)较生存组高,△SOFA 48 h较生存组低,差异具有统计学意义(P0.000 1)。PCT-c 48 h,PCT-c 5 d及△SOFA 48 h的ROC曲线下面积分别为0.774(95%CI 0.61~0.93)、0.761(95%CI 0.61~0.91)及0.752(95%CI 0.60~0.90),PCT-c 48 h预测价值最高。结论:PCT-c 48 h,PCT-c 5 d及△SOFA 48 h对于复杂腹腔感染导致严重脓毒症及感染性休克患者预后具有预测价值。PCT-c 48 h降低提示临床医生需重新评估治疗方案的有效性。
[Abstract]:Objective: to investigate the correlation between PCT clearance rate (PCT-c) and infection associated organ failure score (SOFA). Evaluation value of prognosis in patients with complicated abdominal infection methods: retrospective analysis was conducted in the Department of intensive Medicine from 2013 to 2015. 65 patients with severe sepsis and septic shock caused by complicated abdominal infection were divided into survival group and death group. The PCT values were recorded at 48 h and 5 d after diagnosis and PCT-c were calculated. The 48 h SOFA score was recorded on the day of diagnosis. The predictive value of PCT-c and SOFA in complicated abdominal infection was evaluated. Results: the initial PCT value in the death group was higher than that in the survival group. But the difference was not statistically significant. The PCT-c 48 h PCT-c was significantly higher in the survival group than that in the death group (P 0.05). The initial SOFA score of the death group was higher than that of the survival group, and the SOFA 48 h was lower than that of the survival group. The difference was statistically significant (P 0. 000 1 路PCT-c 48 h). The area under the ROC curve of PCT-c 5 d and SOFA 48 h was 0.77495 CI 0.610.93). 0.76195 CI 0.610.91) and 0.75295 CI 0.600.90). PCT-c 48 h was the best predictive value. Conclusion: PCT-c is 48 h. PCT-c 5 d and SOFA 48 h can predict the prognosis of patients with severe sepsis and septic shock caused by complicated abdominal infection. H-reduction suggests that clinicians need to reassess the effectiveness of the treatment regimen.
【作者单位】：上海交通大学医学院附属仁济医院重症医学科;
【分类号】：R459.7
【正文快照】： 复杂腹腔感染(complicated intra-abdominalinfections,c IAI)定义为空腔脏器的内容物穿入腹腔导致局限性腹膜炎(包括脓肿)、弥漫性腹膜炎,感染源经外科处理后,仍残留细菌,需使用抗感染药物。c IAI在ICU致死性感染源中位列第二,早期识别感染控制不良并及时干预是影响疾病转归

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