降钙素原联合肾上腺髓质素前体中段肽在脓毒症诊断中的应用

发布时间：2018-03-02 16:47

本文选题：降钙素原　切入点：肾上腺髓质前体中段肽　出处：《广东医学》2017年09期 　论文类型：期刊论文

【摘要】：目的探讨肾上腺髓质素前体中段肽(MR-proADM)和降钙素原(PCT)在脓毒症诊断中的作用,为临床感染性疾病的诊断提供依据。方法入住ICUS且符合脓毒症诊断标准的患者67例,分为脓毒症组(A组)、严重脓毒症组(B组)、脓毒性休克组(C组),对照组(D组)为健康体检者。患者入住ICU 24 h内抽血检测血浆/血清中MR-pro ADM和PCT浓度,通过建立受试者工作特征曲线分析诊断指标的敏感性、特异性并确立临界值。结果与D组相比,67例脓毒症患者MR-pro ADM及PCT均显著增高(X~2=28.104、25.645,P0.01),A、B、C组之间MR-pro ADM及PCT浓度差异均有统计学意义(P0.01)。MR-proADM曲线下面积(AUC)较PCT的AUC大,其中A组差异最显著,分别为0.917和0.864。A组MR-proADM和PCT敏感性分别为89.0%和84.0%,B组、C组两者敏感性相近,各组使用PCT和MR-proADM联合诊断时敏感性和特异性均优于单个指标。结论随着脓毒症患者病情的加重,PCT和MR-proADM浓度均显著升高,脓毒症病症较轻时MR-proADM对脓毒症的诊断效果优于PCT,两者联合检测效果优于单独检测。
[Abstract]:Objective to investigate the role of MR-proADM and procalcitonin in the diagnosis of sepsis and to provide evidence for the diagnosis of clinical infectious diseases. The patients were divided into sepsis group (group A), severe sepsis group (group B), septic shock group (group C) and control group (group D). The sensitivity of the diagnostic index was analyzed by establishing the operating characteristic curve of the subjects. Results compared with group D, MR-proADM and PCT in 67 patients with sepsis were significantly higher than those in group D. Results there were significant differences in MR-proADM and PCT concentrations between group C and group C (P 0.01), and the area under the curve of PCT was significantly higher in group A than in group A, and the difference was most significant in group A. The sensitivities of MR-proADM and PCT were 89.0% and 84.0 in group B and 0.864.A, respectively. The sensitivity and specificity of the combined diagnosis of PCT and MR-proADM in each group were better than that of a single index. Conclusion with the aggravation of sepsis patients, the concentrations of PCT and MR-proADM increased significantly. The diagnostic effect of MR-proADM on sepsis is better than that of PCT when the sepsis is mild.
【作者单位】：惠州市第一人民医院检验科;惠州市医学研究所;惠州市第一人民医院肿瘤内科;
【基金】：惠州市科技计划(医疗卫生)项目(编号:2016Y104)
【分类号】：R459.7

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