CAJ | 학술논문

目的探讨血浆DNA浓度评估脓毒症患者预后的准确性.方法随机选取160例脓毒症患者作为脓毒症组(SE组),选取109例非脓毒症患者作为对照组(C组).入院时抽取外周静脉血样,采用PCR法、酶联免疫吸附试验法分别测定血浆DNA浓度和C反应蛋白(CRP)浓度,记录入院24h内情况最差时急性生理与慢性健康评估Ⅱ评分(APACHEⅡ评分)和序贯器官衰竭评分(SOFA评分).根据存活情况将SE组患者分为存活组(n=103)和死亡组(n=57).结果与C组比较,SE组血浆DNA浓度、CRP浓度、APACHEⅡ评分、SOFA评分升高(P＜0.05)；与存活组比较,死亡组血浆DNA浓度、CRP浓度、APACHEⅡ评分、SOFA评分升高(P＜0.05).血浆DNA浓度、SOFA评分、APACHEⅡ评分曲线下面积分别为0.81(95％CI,0.74～0.88)、0.72(95％ CI,0.63 ～ 0.82)和0.68(95％CI,0.60～0.77).结论血浆DNA浓度可准确评估脓毒症患者预后,与CRP浓度、APACHEⅡ评分、SOFA评分比较,血浆DNA浓度预测脓毒症患者的预后准确性更高.
목적 탐토혈장DNA농도평고농독증환자예후적준학성.방법 수궤선취160례농독증환자작위농독증조(SE조),선취109례비농독증환자작위대조조(C조).입원시추취외주정맥혈양,채용PCR법、매련면역흡부시험법분별측정혈장DNA농도화C반응단백(CRP)농도,기록입원24h내정황최차시급성생리여만성건강평고Ⅱ평분(APACHEⅡ평분)화서관기관쇠갈평분(SOFA평분).근거존활정황장SE조환자분위존활조(n=103)화사망조(n=57).결과 여C조비교,SE조혈장DNA농도、CRP농도、APACHEⅡ평분、SOFA평분승고(P＜0.05)；여존활조비교,사망조혈장DNA농도、CRP농도、APACHEⅡ평분、SOFA평분승고(P＜0.05).혈장DNA농도、SOFA평분、APACHEⅡ평분곡선하면적분별위0.81(95％CI,0.74～0.88)、0.72(95％ CI,0.63 ～ 0.82)화0.68(95％CI,0.60～0.77).결론 혈장DNA농도가준학평고농독증환자예후,여CRP농도、APACHEⅡ평분、SOFA평분비교,혈장DNA농도예측농독증환자적예후준학성경고.
Objective To investigate the accuracy of the plasma DNA concentration in evaluating the prognosis in patients with sepsis.Methods One hundred and sixty patients with sepsis were enrolled as the sepsis group (group SE).Another 109 patients without sepsis hospitalized during the same period served as the control group (group C).The venous blood sample was taken on admission for determination of plasma DNA concentration by polymerase chain reaction,C reactive protein (CRP) concentration by ELISA.APACHE Ⅱ score and SOFA score were evaluated at 24 h after admission.The 160 patients with sepsis were divided into two groups according to the result of prognosis:survival group ( n =103) and death group ( n =57).Results Compared with group C,the plasma DNA concentration,CRP concentration,APACHE Ⅱ score and SOFA score were significantly increased in group SE (P＜0.05).Compared with survival group,the plasma DNA concentration,APACHEⅡ score and SOFA score were significantly increased in death group ( P ＜ 0.05).The areas under receiver operating characteristic (ROC) curves of the plasma DNA concentration was significantly larger than those of APACHE Ⅱ score and SOFA score (0.81(95％ CI,0.74-0.88) versus 0.68(95％ CI,0.60-0.77),or 0.72(95％ CI,0.63-0.82)).Conclusion The plasma DNA concentration can accurately evaluate the prognosis in patients with sepsis.As compared with the plasma CRP concentration,APACHE Ⅱ score and SOFA score,the plasma DNA concentration is more accurate to evaluate the prognosis in patients with sepsis.