CAJ | 학술논문

目的：探讨血浆降钙素原（PCT）在鉴别脓毒血症及判断脓毒血症严重程度方面的价值。方法选择本院收治的脓毒症患者70例，根据患者病情严重程度分为一般脓毒症组（n ＝23）、严重脓毒症组（n ＝28）和脓毒症休克组（n ＝19），于入院1 h 内应用抗生素治疗前测定患者血浆 PCT、乳酸、C 反应蛋白，并计算24 h 急性生理和慢性健康状态评分Ⅱ（APACHEⅡ），住院第1、2、3天均测定患者血清 PCT、乳酸、C 反应蛋白。结果严重脓毒症组、脓毒症休克组患者血浆 PCT、乳酸、CRP 和 A-PACHEⅡ评分明显高于一般脓毒症组（P ＜0．05）；脓毒症休克组患者血清 PCT、CRP 和 APACHEⅡ评分明显高于严重脓毒症组（P ＜0．05）；70例脓毒症患者死亡15例，存活55例，死亡组72 h 血浆 PCT、乳酸、CRP 和 APACHEⅡ评分明显高于存活组（P ＜0．01）；脓毒症患者入院时 PCT 与 APACHEⅡ评分呈正相关（r ＝0．528，P ＜0．01）。结论 PCT 优于目前临床上应用的CRP 炎症反应参数，可作为早期鉴别全身感染及判断脓毒血症严重程度及预后的有效指标。
목적：탐토혈장강개소원（PCT）재감별농독혈증급판단농독혈증엄중정도방면적개치。방법선택본원수치적농독증환자70례，근거환자병정엄중정도분위일반농독증조（n ＝23）、엄중농독증조（n ＝28）화농독증휴극조（n ＝19），우입원1 h 내응용항생소치료전측정환자혈장 PCT、유산、C 반응단백，병계산24 h 급성생리화만성건강상태평분Ⅱ（APACHEⅡ），주원제1、2、3천균측정환자혈청 PCT、유산、C 반응단백。결과엄중농독증조、농독증휴극조환자혈장 PCT、유산、CRP 화 A-PACHEⅡ평분명현고우일반농독증조（P ＜0．05）；농독증휴극조환자혈청 PCT、CRP 화 APACHEⅡ평분명현고우엄중농독증조（P ＜0．05）；70례농독증환자사망15례，존활55례，사망조72 h 혈장 PCT、유산、CRP 화 APACHEⅡ평분명현고우존활조（P ＜0．01）；농독증환자입원시 PCT 여 APACHEⅡ평분정정상관（r ＝0．528，P ＜0．01）。결론 PCT 우우목전림상상응용적CRP 염증반응삼수，가작위조기감별전신감염급판단농독혈증엄중정도급예후적유효지표。
Objective To explore the value of plasma procalcitonin (PCT)detection in dif-ferentiation and judgment of severe pyemia.Methods 70 patients with pyemia were divided into general pyemia group (n =23),severe pyemia group (n =28)and pyemia shock group (n =19), and plasma PCT,lactic acid,c-reactive protein,the acute physiology and chronic health evaluationⅡ 24 hours (APACHE Ⅱ)and 1,2,3 days in hospital as well as serum PCT,lactic acid,c-reac-tive protein were detected and compared.Results Plasma PCT,lactic acid,CRP and APACHE Ⅱscore of pyemia shock patients were significantly higher than the general pyemia group (P <0.05). Serum PCT,CRP and APACHE Ⅱ score of pyemia shock patients were significantly higher than that of severe pyemia group (P <0.05).15 patients with pyemia died,55 patients survived.72 hours plasma PCT,lactic acid,CRP and APACHE Ⅱ score in death group were significantly higher than the survival group (P < 0.01).When pyemia patients were admitted to hospital,PCT were positively correlated with APACHE Ⅱ scores (r =0.528,P <0.01).Conclusion PCT is superior to the current clinical application of CRP inflammatory response parameters,and it can be used as an early identification of systemic infection,judgment of pyemia severity and prognosis judgment in-dex.