降钙素原对外科ICU全身炎症反应综合征患者病因诊断及预后的价值

发布时间：2018-04-22 17:52

  本文选题：降钙素原 + 脓毒症　； 参考：《医学研究生学报》2016年07期

【摘要】：目的全身炎症反应综合征(systemic inflammatory response syndrome,SIRS)可由感染和非感染因素引起,两者临床特征相似,但治疗和预后不同,需尽早区分。降钙素原(procalcitonin,PCT)在感染时快速大量合成,可作为早期快速诊断脓毒症的血清生物标志。文中回顾性分析血清PCT水平对外科ICU病房SIRS患者的病因诊断与预后价值。方法选择2014年6月1日至2015年6月1日期间南京军区南京总医院外科监护病房166例SIRS患者的数据进行分析,其中包括患者基本情况、原发疾病、实验室结果及临床转归。分析比较血培养结果、临床转归及血清PCT测定值。结果 166例SIRS患者中脓毒症131例,PCT中位数浓度为2.43(0.81~10.51)ng/m L,其中109例血清PCT阳性(≥0.47 ng/m L),阳性率为83.2%;非感染性SIRS 35例,PCT中位数浓度为0.23(0.10~0.39)ng/m L,阳性率为17.14%。2组患者血清PCT及阳性率比较,差异有统计学意义(P0.05)。细菌和真菌所致脓毒症患者PCT阳性率分别为86.5%(83/96)和74.3%(26/35),中位数浓度分别为4.28(1.05~14.59)和0.89(0.37~1.59)ng/m L,细菌感染组显著高于真菌感染组(P0.05)。脓毒症死亡和存活患者血清PCT阳性率分别为94.4%(34/36)和78.9%(75/95),中位数浓度分别为12.89(4.76~47.73)和1.41(0.54~4.00)ng/m L,两者阳性率及血清PCT水平比较差异均有统计学意义(P0.05)。结论血清PCT水平可成为区分脓毒症和非感染SIRS的重要依据。细菌感染脓毒症患者血清PCT水平明显高于真菌感染组;脓毒症死亡组患者血清PCT水平显著高于存活患者。血清PCT测定有助于SIRS病因诊断和预后。
[Abstract]:Objective systemic inflammatory response syndrome (SIRs) can be caused by infection and non-infection. The clinical characteristics of the two are similar, but the treatment and prognosis are different, so it is necessary to distinguish them as soon as possible. Procalcitonin (PCT) is synthesized rapidly and in large quantities during infection, which can be used as a serum biomarker for early diagnosis of sepsis. The value of serum PCT level in etiological diagnosis and prognosis of SIRS patients in surgical ICU ward was analyzed retrospectively. Methods the data of 166 patients with SIRS in surgical ward of Nanjing General Hospital of Nanjing military region from June 1, 2014 to June 1, 2015 were analyzed, including the basic condition of patients, primary diseases, laboratory results and clinical outcome. The results of blood culture, clinical outcome and serum PCT were analyzed and compared. Results the median concentration of SIRS was 2.43(0.81~10.51)ng/m L in 131 patients with sepsis, in which 109 cases were positive for PCT (鈮，

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