摘要
目的:探索血清降钙素原(PCT)水平结合APACHEⅡ评分对呼吸道感染性疾病治疗及预后预测的应用价值,为临床合理用药提供依据。方法:根据2001年卫生部颁布的医院感染诊断标准,选取2013年12月至2014年12月期间在我院呼吸科住院的呼吸道感染性疾病患者86例(其中细菌感染组47例和病毒感染组39例)和非感染性疾病患者73例,收集相关的临床资料,研究对象均在住院后当天或次日凌晨抽取静脉血5ml进行降钙素原(PCT)检测,同时采末梢静脉血进行血清C-反应蛋白(Hs-crp)的检测并送检血常规。随访呼吸道感染性疾病组28d后治疗结局,以生存与否分为生存组(69例)和死亡组(17例)。对各组的检测结果行统计学处理,检验其差异有无统计学意义。分析方法:各组数据比较用SPSS 16.0软件包进行统计学分析,检测数据服从正态分布的用均数±标准差表示,应用t检验等方法进行检测,若方差不齐则采用改良t检验,各组间构成比率的比较采用χ2检验。相关分析采用非参数Pearson相关分析,以α=0.05为检验水准。结果:呼吸道非感染组、感染组的PCT、hs-CRP及WBC计数较正常对照组均出现升高,但感染组升高更为显著,且在感染组中细菌感染组PCT水平明显高于病毒感染组(P<0.05)。在死亡组中,APACHEⅡ评分、降钙素原血清水平显著较存活组高(P<0.05),说明APACHEⅡ评分、降钙素原对气道感染性疾病的结局有一定的预测作用,但APACHEⅡ评分对预后的预测价值要大于降钙素原。结论:血清降钙素原的检测为感染性疾病的诊断提供依据,同时可以很好的鉴别细菌感染和病毒感染,为抗生素临床应用的提供指导价值;APACHEⅡ评分具有危重病的预后的预测意义,通过降钙素原检测结合APACHEⅡ评分可以为临床治疗方案的制定提供理论基础,同时优化医疗资源配置。
Objective: To explore the serum procalcitonin(PCT)levels combined score APACHEⅡ respiratory infections treatment and prognosis of value to provide a basis for rational drug use.Methods:According to 2001 Ministry of Health issued the hospital infection diagnostic criteria selected in December 2013 to 2014, 12 patients with respiratory tract infections in our hospital during the month of Respiratory hospital 86 cases(including 47 cases of bacterial infection and viral infection 39 cases)and in patients with non-infectious diseases 73 cases, collect relevant clinical data, the subjects were drawn in the same day or the next morning after hospitalization were 5ml blood procalcitonin(PCT)testing, peripheral venous blood serum taken at the same time C- reactive protein(Hs-crp)blood testing and inspection. Follow-up of respiratory infections group 28d after treatment outcome in survival were divided into survival group(69 cases)and death group(17 cases). Line statistical test results for each group, testing whether the difference was statistically signiifcant. Analysis:each set of data for comparison SPSS 16.0 statistical analysis software package, test data follow a normal distribution with a mean ± standard deviation said t test methods for testing, if the variance missing the modiifed t-test between the groups constituteχ2 test was used to compare ratios. Pearson correlation analysis was performed using non-parametric correlation analysis to test the level of α =0.05. Results:Non-respiratory infection, PCT infection group, hs-CRP and WBC count than the normal control group appeared increased, but more signiifcant increase in infection and bacterial infection in the infected group was signiifcantly higher than the group PCT virus infected group(P<0.05). In death group, APACHEⅡ score, serum calcitonin levels significantly higher than the original set of high survival(P<0.05), illustrate APACHEⅡ score, procalcitonin on the outcome of airway infections have some predict, but APACHEⅡ score for prognostic value greater than procalcitonin. Conclusion:Serum procalcitonin testing provide the basis for the diagnosis of infectious diseases at the same time can be a good identiifcation of bacterial infections and viral infections, to provide guidance on the value of the clinical application of antibiotics; APACHEⅡ ratings have critical illness prognostic signiifcance, by combining APACHEⅡ procalcitonin grading can provide a theoretical basis for the development of clinical programs, while optimizing the allocation of resources healthcare.
出处
《中国医药导刊》
2015年第12期1189-1191,共3页
Chinese Journal of Medicinal Guide
