摘要
目的探讨重症肺炎并发脓毒症患者中血清降钙素原(PCT)、血乳酸(Lac)及内毒素水平的变化研究。方法收集陕西省人民医院重症医学科40例重症肺炎并发脓毒症患者(观察组),分为存活组20例和死亡组20侧,入院后进行急性生理与慢性健康评分(APACHEⅡ评分),选入院后最初24 h内评分最差值。同时选取20例健康体检人群作为正常对照组,比较各组血清PCT,血Lac及内毒素的水平,对血清PCT,血Lac,内毒素及APACHEⅡ评分进行相关性研究。结果与正常对照组(0.02±0.01 ng/ml,0.87±0.27 mmol/L,4.15±1.63 pg/ml)比较,观察组血清PCT,血Lac及内毒素水平均升高(18.29±11.02 ng/ml,6.55±3.02 mmol/L和15.5±10.38 pg/m1),差异均有统计学意义(t=10.48,11.79,6.75,均P<0.05);与存活组(9.52±2.93 ng/ml,4.26±1.78 mmol/L,7 62±3.04 pg/m1)比较,死亡组血清PCT,血Lac及内毒素水平均升高(27.06±8.88 ng/ml,8.84±2.14 mmol/IL和23.39±9.00 pg/m1),差异均有统计学意义(t=8.39,7.35,7.42,均P<0.05);血清PCT,血Lac,内毒素与APACHEⅡ评分之间呈正相关(r=0.919,P=0.001;r=0.914,P=0.002;r=0.909,P=0.004)。结论血清PCT,血Lac及内毒素是评估重症肺炎并发脓毒症患者病情严重程度和预后的重要指标。
Objective To evaluate the clinical value of the level of plasma procalcitonin,blood lactic acid and endotoxin in pa- tients of severe pneumonia complicated with sepsis. Methods The 40 cases of severe pneumonia complicated with sepsis（ob- servation group）were analyzed retrospectively,they were divided into survival group included 20 cases and the death group included 20 cases. Meanwhile the 20 cases of healthy persons were selected as control group. The worst score of Acute Phys- iology and Chronic Health Evaluation Ⅱ （APACHE Ⅱ ） within 24 hours after admission were record. The level of plasma procalcitonin,blood lactic acid and endotoxin were compared between three groups. In addition do a correlation study be- tween the above indexes and the score of APACHE Ⅱ. Results The level of plasma Procalcitonin,blood lactic acid and en- dotoxin of observation group increased significantly compared with the control group [（0.02 ± 0.01 ng/ml, 0.87± 0.27 mmol/L,4. 15±1.63 pg/ml） vs （18.29±11.02 ng/ml, 6. 55 ± 3. 02 mmol/L and 15.5±10.38 pg/ml）,t=10. 48,11.79, 6.75,all P〈0. 051. The level of plasma procalcitonin, blood lactic acid and endotoxin of the death group increased signifi- cantly compared with the survival group [（9.52±2.93 ng/ml,4. 26±1.78 retool/L,7.62±3.04 pg/ml） vs （27.06±8.88 ng/ml,8.84±2.14 mmol/L and 23.39±9.00 pg/ml） ,t=8.39,7.35,7.42,all P〈0. 051. In the all patients of severe pneu- monia complicated with sepsis, there was positive correlation among plasma procalcitonin, blood lactic acid, endotoxin and the score of APACHE Ⅱ （r=0. 919,P=0. 001;r=0. 914,P=0. 002;r=0. 909,P：0. 004 ）. Conclusion The level of plasma procalcitonin,blood lactic acid and endotoxin are very important indexes in assessment of the severity and the prognosis of severe pneumonia complicated with sepsis, that has important value in clinical application.
出处
《现代检验医学杂志》
CAS
2017年第2期95-97,164,共4页
Journal of Modern Laboratory Medicine
关键词
重症肺炎
脓毒症
血清降钙素原
血乳酸
内毒素
severe pneumonia
sepsis
plasma procalcitonin（PCT）
blood lactic acid （lac）
endotoxin
