摘要
目的研究血清游离皮质醇对老年危重症感染患者的诊断价值。方法选取2014年12月-2016年12月74例医院全麻术后或急性脑血管意外的老年患者,将其设为试验组,选取同期入院的38例非感染老年患者设为对照组,检测两组患者8:00、16:00血清游离皮质醇、8:00血促肾上腺皮质激素(adrenocorticotropic hormore,ACTH)及血钾水平,分析血清游离皮质醇在老年危重症感染中的检测效果。结果两组患者血钾水平、8:00血ACTH差异无统计学意义;试验组8:00、16:00血清游离皮质醇以及尿游离皮质醇水平高于对照组(P<0.05);试验组患者不同血清游离皮质醇水平的敏感性和特异性差异有统计学意义(P<0.05)。血清游离皮质醇敏感性随着血清皮质醇水平的提高出现下降趋势,而特异性随着血清皮质醇水平的提高呈上升趋势。结论血清游离皮质醇在老年危重症感染者中表达较高,具备较好的诊断敏感性和特异性,联合ACTH、血钾等指标能帮助患者确诊,值得推广应用。
OBJECTIVE To study the value of serum free cortisol in diagnosis of elderly patients with severe infection.METHODS Totally 74 elderly patients who received general anesthesia or had acute cerebrovascular accidents from Dec 2014 to Dec 2016 were assigned as the experimental group,meanwhile,38 elderly patients without infection were set as the control group.The levels of serum free cortisol at 8：00 and 16：00,adrenocorticotropic hormone（ACTH）at 8：00 and serum potassium of the two groups of patients were detected,and the value of the serum free cortisol in diagnosis of the elderly patients with severe infection was observed.RESULTS There was no significant difference in the serum potassium level or serum ACTH at 8：00 between the two groups of patients;the levels of serum free cortisol and urine free cortisol at 8：00 and 16：00 were significantly higher in the experimental group than I the control group（P〈0.05）.There were significant differences in the sensitivity and specificity of different levels of serum free cortisol in the experimental group（P〈0.05）.The sensitivity of the serum free cortisol was decreased with the elevation of serum free cortisol level,while the specificity was increased with the elevation of serum free cortisol level.CONCLUSIONThe level of expression of serum free cortisol is high among the elderly patients with severe infection,the sensitivity and specificity are high,the serum free cortisol combined with ACTH and serum potassium may facilitate the diagnosis,and it is worthy to be promoted.
作者
施丽妮
梁群
吕伟
陈金英
梁凌峰
SHI Li-ni;LIANG Qun;LYU Wei;CHEN Jin-ying;LIANG Ling-feng(People＇s Hospital of Lishui City,Lishui,Zhejiang 323000,Chin)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2018年第14期2084-2086,共3页
Chinese Journal of Nosocomiology
基金
浙江省卫计委医药卫生科技计划基金资助项目(2013KYA079)
