摘要
目的 :探讨降钙素原 (PCT)在鉴别脓毒血症及判断脓毒血症严重程度方面的意义。方法 :选取入ICU的患者 35例 ,其中脓毒血症组 18例与非脓毒血症组 17例 ;脓毒血症组中重度脓毒血症 (SS)组 12例、非重度脓毒血症 (non SS)组 6例。比较脓毒血症与非脓毒血症组间以及SS与non SS组间组的血PCT、C 反应蛋白(CRP)、WBC、淋巴细胞 (PLT)、体温 (T)以及APACHEⅡ评分的差别。结果 :①脓毒血症组患者的PCT值明显高于非脓毒血症组 (P <0 .0 1) ,SS组的血浆PCT值明显高于non SS组 (P <0 .0 5 ) ;②当血浆PCT >2ng/ml时 ,脓毒血症发生率明显增高 (P <0 .0 1)。以PCT >2ng/ml做为诊断脓毒血症的标准 ,得出的敏感性、特异性及准确性分别为 72 .2 2 % ,88.2 4 % ,80 % ;③脓毒血症与非脓毒血症组的CRP、APACHEⅡ及WBC比较均有显著性差别 (P <0 .0 5 ,P <0 .0 1,P <0 .0 5 ) ,而T及PLT则无明显区别 ;④SS组与non SS组的CRP、APACHEⅡ、WBC、T及PLT比较 ,除APACHEⅡ外 ,其余的各参数间均未显示有统计学意义的差别。结论 :PCT优于目前临床上应用的炎症反应参数 ,可作为早期鉴别全身感染 ,尤其是细菌感染的快捷、敏感、准确的检测手段。
Objective: To explore the significance of plasma procalcitonin(PCT) in distinguishing sepsis from other diseases and estimating the degree of severity of sepsis. Methods: 35 patients admitted to ICU were separated into two groups: group of sepsis(18 cases) and group of non-sepsis(17 cases). Group of sepsis was further divided into severe sepsis(SS)(12 cases) and non-severe sepsis(non-SS)(6 cases). Comparing the differences of plasma procalcitonin(PCT), C-reactive protein(CRP), white blood cell(WBC), platelet(PLT), temperature(T) and APACHEⅡbetween the groups of sepsis and non-sepsis, SS and non-SS. Results: ①The level of PCT in sepsis was significantly higher than that in non-sepsis( P <0.01), and the level of PCT in the group of SS was significantly higher than that in the group of non-SS( P <0.05);②The morbility of sepsis was evidenfily increased when PCT>2 ng/ml ( P <0.01).The sensitivity, specificity and accuracy were 72.22%,88.24%and 80%,respectively when PCT>2 ng/ml was taken as the standard of diagnosis for sepsis. ③CRP?APACHEⅡ and WBC between the groups of sepsis and non-sepsis showed significant differences ( P <0.05, P <0.01, P <0.05, respectively), and there were no differences for T and PLT between sepsis and non-sepsis. ④There were no significant differences for CRP?WBC?T and PLT between the groups of SS and non-SS excepting APACHEⅡ. Conclusion:PCT is a better inflammatory reactive parameter than others applied currently and may become a rapid test with,Sensitivity and accuracy property in confirming sepsis, especially bacterial sepsis, in the early stage of the disease.
出处
《中日友好医院学报》
2004年第2期73-76,共4页
Journal of China-Japan Friendship Hospital
