血清PCT与PCT清除率在呼吸机相关性肺炎感染疗效及预后的评估价值

发布时间：2018-06-22 22:27

本文选题：降钙素原 + 降钙素原清除率　；参考：《中华医院感染学杂志》2017年24期

【摘要】：目的探讨血清降钙素原(PCT)、降钙素原清除率(PCT-c)在呼吸机相关性肺炎(VAP)感染患者疗效及预后中的评估价值。方法采用单中心回顾性研究,纳入2015年1月-2016年12月医院ICU住院治疗、符合VAP诊断标准的70例患者。记录患者一般临床资料,患者入院后均给予经验性抗感染治疗,于10d后评估疗效,并分为恶化组和好转组,每组各35例。取确诊VAP时患者第5、7、9天清晨血,检测血清PCT并计算PCTc。比较两组患者不同治疗时间点PCT和PCT-c是否存在差异;ROC分析PCT和PCT-c对VAP感染患者预后的预测效力。结果随着治疗时间的延长,好转组的PCT水平下降,恶化组仍保持较高水平;恶化组确诊第5、7和9天时PCT水平高于好转组(P0.05);好转组患者PCT-c保持高水平,且随着病情好转而逐渐升高;恶化组PCT-c较低,随着病情进展而逐渐下降;恶化组确诊第5、7和9天时PCT-c低于好转组(P0.05);ROC分析显示,确诊后第9天PCT和PCT-c对VAP患者预后预测的敏感性和特异性最高。结论 PCT和PCT-c可以较好地预测VAP感染患者的预后,PCT-c的预测效力要优于PCT绝对值。
[Abstract]:Objective to evaluate the efficacy and prognosis of serum procalcitonin (PCT) and procalcitonin clearance (PCT-c) in patients with ventilator-associated pneumonia (VAP). Methods A single center retrospective study was carried out in 70 patients who were admitted to ICU from January 2015 to December 2016 and met the diagnostic criteria of VAP. The general clinical data of the patients were recorded. The patients were treated with experiential anti-infective therapy after admission. After 10 days of treatment, the patients were evaluated and divided into two groups: the worsening group and the improvement group, with 35 cases in each group. Serum PCT was measured and PCTc was calculated in patients with VAP. The prognostic efficacy of PCT and PCT-c in patients with VAP infection was analyzed by ROC. Results with the prolongation of the treatment time, the PCT level in the improvement group decreased, and the PCT level in the worsening group remained high, and the PCT level in the worsening group was higher than that in the improvement group on the 7th and 9th day after diagnosis (P0.05), and the PCT-c level remained high in the improved group. PCT-c in the worsening group was lower than that in the improvement group, and decreased gradually with the progression of the disease, and the PCT-c level in the worsening group was lower than that in the improvement group (P0.05) on the 7th and 9th day after diagnosis (P0.05). PCT and PCT-c had the highest sensitivity and specificity in predicting the prognosis of VAP patients on the 9th day after diagnosis. Conclusion PCT and PCT-c can predict the prognosis of patients with VAP infection better than the absolute value of PCT.
【作者单位】：慈溪市人民医院重症医学科;
【基金】：浙江省医药卫生科技基金资助项目(2016KYB308)
【分类号】：R563.1

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