CAJ | 학술논문

目的：探讨降钙素原（procalcitonin，PCT）及内毒素对于腹腔感染脓毒症患者预后的评估价值。方法回顾性分析腹腔感染脓毒症86例的临床资料，根据预后（存活和死亡）和病情严重程度（局部感染、脓毒症、严重脓毒症及脓毒症休克）分组，比较不同组别之间的PCT及内毒素水平，比较PCT和内毒素同急性生理和慢性健康状况评分Ⅱ（ acute physiology and chronic health evaluation Ⅱ，APACHE Ⅱ）和脓毒症相关器官功能障碍评分（ sepsis-related organ failure assessment score ，SO-FA）的相关性，并比较PCT、内毒素和两个临床评分系统对于患者预后的评估价值。结果根据不同评分及预后分组，各组之间PCT水平差异具有统计学意义，而内毒素水平差异无统计学意义。 PCT与两个评分系统具有很好的相关性，而内毒素与评分系统无显著相关。 PCT、内毒素、APACHE Ⅱ和SOFA评分对于预后的受试者工作特征曲线（ ROC 曲线）下面积分别为85.7％、56．3％、86．7％和86.0％。结论 PCT较内毒素能更好地评价腹腔感染脓毒症患者的预后。
목적：탐토강개소원（procalcitonin，PCT）급내독소대우복강감염농독증환자예후적평고개치。방법회고성분석복강감염농독증86례적림상자료，근거예후（존활화사망）화병정엄중정도（국부감염、농독증、엄중농독증급농독증휴극）분조，비교불동조별지간적PCT급내독소수평，비교PCT화내독소동급성생리화만성건강상황평분Ⅱ（ acute physiology and chronic health evaluation Ⅱ，APACHE Ⅱ）화농독증상관기관공능장애평분（ sepsis-related organ failure assessment score ，SO-FA）적상관성，병비교PCT、내독소화량개림상평분계통대우환자예후적평고개치。결과근거불동평분급예후분조，각조지간PCT수평차이구유통계학의의，이내독소수평차이무통계학의의。 PCT여량개평분계통구유흔호적상관성，이내독소여평분계통무현저상관。 PCT、내독소、APACHE Ⅱ화SOFA평분대우예후적수시자공작특정곡선（ ROC 곡선）하면적분별위85.7％、56．3％、86．7％화86.0％。결론 PCT교내독소능경호지평개복강감염농독증환자적예후。
Objective To evaluate the value of serum procalcitonin and endotoxin concentrations in prognosis of intra -abdom-inal sepsis.Methods A total of 86 patients with intra-abdominal sepsis were included into the study .We compared PCT and endotoxin concentrations according to classification of different outcomes ( survivors and nonsurvivors ) and intra-abdominal sepsis ( local infec-tions,sepsis,severe sepsis and septic shock ).The correlation of PCT or endotoxin concentrations to APACHE Ⅱ or SOFA score were also analyzed ,then see their function in judging the prognosis of sepsis .Results Nonsurvivors had a higher level of PCT than survi-vors.PCT concentrations was higher in patients with severe sepsis and septic shock than that with sepsis or local infections .PCT concen-trations was associated with APACHE Ⅱand SOFA score significantly ,but not endotoxin .The area under ROC curve for predicting 28-days mortality of PCT,endotoxin,APACHEⅡand SOFA score were 85.7%,56.3%,86.7%and 86.0%,respectively.Conclusion PCT had a higher prognostic value in intra-abdominal sepsis than endotoxin .