中国全科医学2017，Vol.20Issue(5)：520-525,6.DOI:10.3969/j.issn.1007-9572.2017.05.004
脓毒症患者血清降钙素原的表达及其对预后的影响研究
Expression of Serum Procalcitonin and Its Impact on Prognosis in Sepsis
摘要
Abstract
Objective To investigate the expression of serum procalcitonin(PCT)level and impact on prognosis in sepsis. Methods A total of 216 patients who were hospitalized the Intensive Care Unit,Danzhou City People′s Hospital and definitely diagnosed with sepsis from March 2012 to March 2016 were enrolled in this study. And they were divided into the survival group(n = 134)and death group(n = 82)based on the treatment outcome showed by a 28 - day follow - up. Other 188 non - sepsis patients hospitalized in the hospital during the same period were selected as the subjects,too. We recorded all the subjects′ Acute Physiology and Chronic Health Evaluation Ⅱ( APACHE Ⅱ)score,Sequential Organ Failure Assessment (SOFA)score,levels of serum PCT,C - reactive protein(CRP)and brain natriuretic peptide(BNP). The factors affecting the prognosis of sepsis were analyzed with a multivariate Logistic regression model and their roles in predicting the prognosis of sepsis were investigated. Results Compared with the non - sepsis patients,sepsis patients had higher APACHE Ⅱ score, SOFA score,serum PCT level,CRP level and BNP level(P < 0. 01). The serum PCT levels on the 1st,3rd and 5th days of admission,and both the serum CRP and BNP levels on the 3rd and 5th days of admission were higher in the death group than those in the survival group(P < 0. 05). Patients in the death group were older,and they had higher APACHEⅡ,SOFA scores and AST compared with those in the survival group(P < 0. 05). Results of multivariate Logistic regression analysis demonstrated that the factors affecting the prognosis of sepsis were age〔OR = 7. 284,95% CI(3. 605,14. 727),P < 0. 05〕,APACHEⅡscore〔OR = 3. 162,95% CI(1. 528,10. 629),P < 0. 05〕,SOFA score〔OR = 3. 015,95% CI(1. 054,9. 582),P <0. 05〕,serum PCT〔OR = 1. 046,95% CI(1. 002,1. 516),P < 0. 05〕,CRP〔OR = 0. 863,95% CI(0. 715,0. 985), P < 0. 05〕and BNP〔OR = 0. 795,95% CI(0. 653,0. 952),P < 0. 05〕. ROC curve analysis indicated that the area under curve(AUC)and optimal threshold of age,APACHEⅡ scoring,SOFA scoring,PCT,CRP and BNP levels for predicting death in sepsis respectively was 0. 803(63. 0 years),0. 826(22. 3 points),0. 765(7. 1 points),0. 849(6. 9 μg/ L), 0. 684(49 mg/ L),0. 626(825 ng/ L). Pearson correlation analysis revealed that in the death group,the level of serum PCT was positively correlated with age,APACHE Ⅱ score,SOFA score,CRP and BNP levels( P < 0. 05). Conclusion The level of serum PCT is significantly elevated in patients with sepsis. Older age,higher APACHE Ⅱ and SOFA scores,higher PCT,CRP and BNP levels are independent risk factors for prognosis in sepsis.关键词
脓毒症/降钙素原/重症监护病房/危险因素Key words
Sepsis/Procalcitonin/Intensive care unit/Risk factors分类
医药卫生引用本文复制引用
谭德敏,谭孟源,陈军,蒙振发,王御林..脓毒症患者血清降钙素原的表达及其对预后的影响研究[J].中国全科医学,2017,20(5):520-525,6.基金项目
海南省医药卫生科研基金项目 （）
