安徽医药
安徽醫藥
안휘의약
ANHUI MEDICAL AND PHARMACEUTICAL JOURNAL
2015年
5期
875-878
,共4页
周登川%王楠%方芳%张泓
週登川%王楠%方芳%張泓
주등천%왕남%방방%장홍
降钙素原%降钙素原变化率%脓毒症%急诊重症监护室
降鈣素原%降鈣素原變化率%膿毒癥%急診重癥鑑護室
강개소원%강개소원변화솔%농독증%급진중증감호실
procalcitonin%procalcitonin clearance%sepsis%emergency intensive care unit
目的:探讨静脉血中降钙素原(Procalcitonin,PCT)及其变化率在评估脓毒症患者预后中的价值。方法对急诊重症监护室收治的72例脓毒症患者,分别于入室即刻(PCT1)、入室后72 h(PCT2)检测静脉血中PCT含量,并计算PCT变化率。患者入室后24 h内利用急性生理学和慢性健康状况评价Ⅱ(APACHEⅡ)进行评分。以患者入室后28 d生存状况,将患者分为存活组(52例)和死亡组(20例),比较两组患者不同时点静脉血中PCT含量、PCT变化率及APACHEⅡ评分对预测患者预后的价值。结果存活组和死亡组患者入室即刻PCT含量分别为14.72μg·L-1(7.82~20.25μg·L-1)比18.25μg·L-1(13.43~21.83μg·L-1),两组差别有统计学意义(P=0.047);存活组和死亡组患者72 h PCT含量分别为4.11μg·L-1(2.03~8.22μg·L-1)比12.33μg·L-1(8.21~15.76μg·L-1),两组差别有统计学意义(P=0.000);存活组和死亡组患者PCT变化率依次为0.718(0.589~0.827)比0.365(0.256~0.57),两组差别有统计学意义(P=0.000)。PCT变化率预测患者预后价值同APACHEⅡ评分一致,但优于不同时点静脉血中PCT含量,其ROC曲线下面积(AUC)为0.814,敏感度82.7%,特异度75%。结论患者静脉血中PCT变化率可作为判断脓毒症患者预后的指标之一,其预测能力优于入室即刻PCT和72 h PCT含量的预测能力。
目的:探討靜脈血中降鈣素原(Procalcitonin,PCT)及其變化率在評估膿毒癥患者預後中的價值。方法對急診重癥鑑護室收治的72例膿毒癥患者,分彆于入室即刻(PCT1)、入室後72 h(PCT2)檢測靜脈血中PCT含量,併計算PCT變化率。患者入室後24 h內利用急性生理學和慢性健康狀況評價Ⅱ(APACHEⅡ)進行評分。以患者入室後28 d生存狀況,將患者分為存活組(52例)和死亡組(20例),比較兩組患者不同時點靜脈血中PCT含量、PCT變化率及APACHEⅡ評分對預測患者預後的價值。結果存活組和死亡組患者入室即刻PCT含量分彆為14.72μg·L-1(7.82~20.25μg·L-1)比18.25μg·L-1(13.43~21.83μg·L-1),兩組差彆有統計學意義(P=0.047);存活組和死亡組患者72 h PCT含量分彆為4.11μg·L-1(2.03~8.22μg·L-1)比12.33μg·L-1(8.21~15.76μg·L-1),兩組差彆有統計學意義(P=0.000);存活組和死亡組患者PCT變化率依次為0.718(0.589~0.827)比0.365(0.256~0.57),兩組差彆有統計學意義(P=0.000)。PCT變化率預測患者預後價值同APACHEⅡ評分一緻,但優于不同時點靜脈血中PCT含量,其ROC麯線下麵積(AUC)為0.814,敏感度82.7%,特異度75%。結論患者靜脈血中PCT變化率可作為判斷膿毒癥患者預後的指標之一,其預測能力優于入室即刻PCT和72 h PCT含量的預測能力。
목적:탐토정맥혈중강개소원(Procalcitonin,PCT)급기변화솔재평고농독증환자예후중적개치。방법대급진중증감호실수치적72례농독증환자,분별우입실즉각(PCT1)、입실후72 h(PCT2)검측정맥혈중PCT함량,병계산PCT변화솔。환자입실후24 h내이용급성생이학화만성건강상황평개Ⅱ(APACHEⅡ)진행평분。이환자입실후28 d생존상황,장환자분위존활조(52례)화사망조(20례),비교량조환자불동시점정맥혈중PCT함량、PCT변화솔급APACHEⅡ평분대예측환자예후적개치。결과존활조화사망조환자입실즉각PCT함량분별위14.72μg·L-1(7.82~20.25μg·L-1)비18.25μg·L-1(13.43~21.83μg·L-1),량조차별유통계학의의(P=0.047);존활조화사망조환자72 h PCT함량분별위4.11μg·L-1(2.03~8.22μg·L-1)비12.33μg·L-1(8.21~15.76μg·L-1),량조차별유통계학의의(P=0.000);존활조화사망조환자PCT변화솔의차위0.718(0.589~0.827)비0.365(0.256~0.57),량조차별유통계학의의(P=0.000)。PCT변화솔예측환자예후개치동APACHEⅡ평분일치,단우우불동시점정맥혈중PCT함량,기ROC곡선하면적(AUC)위0.814,민감도82.7%,특이도75%。결론환자정맥혈중PCT변화솔가작위판단농독증환자예후적지표지일,기예측능력우우입실즉각PCT화72 h PCT함량적예측능력。
Objective To investigate the prognostic value of procalcitonin (PCT)and PCT clearance in patients with sepsis in emer-gency intensive care unit (EICU).Methods 72 cases with sepsis were included in the present study.PCT was measured at admis-sion,72 hours after admission and the PCT clearance was also calculated.Meanwhile,Acute Physiology and Chronic Health Evaluation II (APACHE II)score was recorded within 24 hours.Patients were divided into two groups (survivors and non-survivors)according to 28d mortality.The PCT of two different points,PCT clearance,and APACHE II scores were compared between the survivors and non-survivors Results Significant difference of PCT at admission,72 hours after admission and the PCT clearance were found between the survivors and non-survivors groups with 14.72 μg·L-1 (7.82 ~20.25 μg·L-1 )vs 18.25 μg·L-1 (13.43 ~21.83 μg·L-1 ) (P =0.047),4.11 μg·L-1 (2.03 ~8.22 μg·L-1 )vs 12.33 μg·L-1 (8.21 ~15.76 μg·L-1 )(P =0.000),and 0.718 (0.589~0.827)vs 0.365 (0.256~0.57)(P =0.000),respectively.Prognostic value of the PCT clearance is consistent with A-PACHEⅡ score,but better than the PCT content of the venous blood at different time points.The area under the ROC was 0.849 with sensitivity 78%,specificity 89.2%.Conclusions PCT clearance maybe can be used as a prognostic indicator,which was better than using PCT at admission and 72h after admission.