论文部分内容阅读
目的:结合急性生理与慢性健康评估(APACHEⅡ)探讨降钙素原(procaloitonin,PCT)和其他炎症指标对外科脓毒症病人预后的判断价值。方法:48例外科脓毒症病人根据28 d状况分为生存组(34例)和死亡组(14例)。通过比较两组PCT、白细胞计数(WBC)、中性粒细胞百分比(NE%)、C反应蛋白(c-reactive protein,CRP)和APACHEⅡ的变化,分析PCT等指标与APACHEⅡ的关系。采用受试者工作特征(receiver operating characteristic,ROC)曲线分析外科脓毒症预后。结果:死亡组PCT、CRP和APACHEⅡ显著高于生存组(P<0.05),两组WBC和NE%无差异。Spearman相关分析显示,PCT、CRP与APACHEⅡ呈正相关(P<0.05),WBC和NE%与APACHEⅡ无相关性。ROC曲线分析显示,预测外科脓毒症病人预后的曲线下面积依次为:PCT(0.891)>APACHEⅡ(0.834)>CRP(0.831)。PCT是预测外科脓毒症病人预后的最强因子。当PCT为11.13 ng/m L时,灵敏度和特异度分别为85.7%和85.3%。Logistic回归分析显示,PCT和APACHEⅡ是影响外科脓毒症病人预后的两个独立危险因素(P<0.05)。结论:PCT是评价外科脓毒症病人预后的较好指标。
Objective: To evaluate the prognostic value of procalcitonin (PCT) and other inflammatory markers in patients with surgical sepsis in combination with acute physiology and chronic health assessment (APACHE Ⅱ). Methods: Forty-eight surgical sepsis patients were divided into survival group (34 cases) and death group (14 cases) according to the status of 28 days. The relationship between PCT and APACHEⅡwas analyzed by comparing the changes of PCT, WBC, NE%, C-reactive protein (CRP) and APACHEⅡ. Surgical sepsis prognosis was analyzed using receiver operating characteristic (ROC) curve. Results: The PCT, CRP and APACHEⅡ in death group were significantly higher than those in survival group (P <0.05). There was no difference in WBC and NE% between two groups. Spearman correlation analysis showed that there was a positive correlation between PCT, CRP and APACHEⅡ (P <0.05), and no correlation between WBC and NE% and APACHEⅡ. ROC curve analysis showed that the area under the curve predicting the prognosis of patients with surgical sepsis was: PCT (0.891)> APACHE II (0.834)> CRP (0.831). PCT is the strongest predictor of prognosis in surgical sepsis patients. When PCT was 11.13 ng / m L, the sensitivity and specificity were 85.7% and 85.3%, respectively. Logistic regression analysis showed that PCT and APACHE II were two independent risk factors affecting the prognosis of patients with surgical sepsis (P <0.05). Conclusion: PCT is a good indicator to evaluate the prognosis of surgical sepsis patients.