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、48h及5d时PCT值并计算PCT-c；记录诊断当天、48hSOFA评分，并计算48hASOFA。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（PCT0）较生存组高，但差异无统计学意义。生存组中PCT-C48h、PCT-e5d均高于死亡组，差异具有统计学意义（P〈0．05），死亡组的初始SOFA评分（SOFA。）较生存组高，△SOFA48h较生存组低，差异具有统计学意义（P〈0．0001）。PCT-C48h，PCT-C5d及ASOFA48h的ROC曲线下面积分别为0．774（95％C10．61-0．93）、0．761（95％CI0．61-0．91）及0．752（95％CI0．60-0．90）．PCT-c48h预测价值最高。结论：PCT-C48h，PCT-e5d及ASOFA48h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-C48h降低提示临床医生需重新评估治疗方案的有效性。
Objective To evaluate the value of the clearance of procaleitonin （PCT-e）and △Sequential Organ Failure Assessment（SOFA） in prognosis of intra-abdominal sepsis, Methods A retrospective study conducted in surgical intensive care unit including a total of 65 patients with severe sepsis and septic shock caused by complicated intra-abdominal infections.The PCT-e was determined at the diagnosis of sepsis and after 48 hours and 5 days. The SOFA score was determined at the time of intensive care unit admission and after 48 hours. To evaluate the value of PCT-c and A SOFA in prognosis of intra-abdominal sepsis. Results The initial PCT （PCT0）was higher in nonsurvivors but there was no significance. PCT-c48h、PCT-cSd were significantly higher in survivors （P 〈 0.05）. In nonsurvivors, the initial SOFA （SOFAO） was significantly higher, and the 48-hour SOFA was significantly smaller（P 〈 0.0001）.The area under the receiver operating characteristic curve was 0.774, 0.76 and 0.752for PCT-c48h, PCT-eSd and △SOFA 48 h. Conclusions The clearance of 48-hour and 5-day PCT and 48-hour △SOFA are useful markers of prognosis in patients with severe sepsis and septic shock caused by complex abdominal infection. A decrease in PCT-c in the first 48 hours of treatment should prompt the reassessment of the appropriateness and adequacy of treatment.
出处
《实用医学杂志》
CAS
北大核心
2016年第24期4034-4037,共4页
The Journal of Practical Medicine
关键词
复杂腹腔感染
降钙素原
SOFA评分
预后
Procalcitonin
Complicated intra-abdominal infections
SOFA
Prognosis
