CAJ | 학술논문

目的：评价外周血降钙素原（ PCT）对ICU感染性休克患者预后判断的价值。方法回顾性分析2012－01～2013－01入住ICU的102例感染性休克患者，记录其入院第1、2、3、4、5天外周血PCT水平，根据28 d生存情况分为存活组和死亡组，比较两组患者的PCT水平，并评价其与APACHEⅡ评分、SOFA评分的相关性。结果存活组和死亡组患者第1、2、3天PCT水平比较差异无统计学意义，但死亡组患者第4、5天PCT水平明显高于存活组（P＜0．05）；死亡组乳酸、SOFA评分、APACHEⅡ评分明显高于存活组（ P＜0．05）；入院第4天患者PCT水平与SOFA评分和APACHEⅡ评分呈正相关（r分别为0．389和0畅393，P均＜0．01）；入院第5天患者PCT水平与SOFA评分和APACHEⅡ评分呈正相关（r分别为0．649和0．658，P均＜0．01）；PCT为2．0μg／L时敏感度为81．2％，特异度为72．8％。结论动态监测PCT水平的变化可以有效评估感染性休克患者的预后。
목적：평개외주혈강개소원（ PCT）대ICU감염성휴극환자예후판단적개치。방법회고성분석2012－01～2013－01입주ICU적102례감염성휴극환자，기록기입원제1、2、3、4、5천외주혈PCT수평，근거28 d생존정황분위존활조화사망조，비교량조환자적PCT수평，병평개기여APACHEⅡ평분、SOFA평분적상관성。결과존활조화사망조환자제1、2、3천PCT수평비교차이무통계학의의，단사망조환자제4、5천PCT수평명현고우존활조（P＜0．05）；사망조유산、SOFA평분、APACHEⅡ평분명현고우존활조（ P＜0．05）；입원제4천환자PCT수평여SOFA평분화APACHEⅡ평분정정상관（r분별위0．389화0창393，P균＜0．01）；입원제5천환자PCT수평여SOFA평분화APACHEⅡ평분정정상관（r분별위0．649화0．658，P균＜0．01）；PCT위2．0μg／L시민감도위81．2％，특이도위72．8％。결론동태감측PCT수평적변화가이유효평고감염성휴극환자적예후。
Objective The present study aims to evaluatethe prognostic value of peripheral blood procalcitonin ( PCT ) in ICU patients with septic shock .Methods This retrospective analysis consist of 102 cases of septic shock patients from January 2012 to January 2013 in the intensive care unit of the Second Affiliated Hospital of Harbin Medical University . Peripheral blood PCT levels were continuously determined on admission 1,2,3,4,5 day.The patients were divided into survival group and death group according to 28 d survival.PCT levels, APACHEⅡ score and SOFA score were compared and the correlations were analyzed between the two groups . Results There were no significant differences of PCT on admission 1 d, 2 d and 3 d between survival group and death group , but PCT of the death group on admission 4 d and 5 d were significantly higher than the survival group (P<0.05). Lactic acid, SOFA score and APACHEⅡscore of the death group were significantly higher than those of the survival group(P<0.05).PCT levels in patients on admission 4 d and 5 d were positively correlated with SOFA score and APACHEⅡscore (R were 0.389 and 0.393 on admission 4 d;R were 0.649 and 0.658 on admission 5 d;P<0.01).PCT was 2.0μg/L when the sensitivity was 81.2%and specificity of 72.8%.Conclusion Dynamic monitoring PCT levels can effectively assess the prognosis of patients with septic shock .