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目的:探讨急诊脓毒症死亡风险(MEDS)评分、血清降钙素原(PCT)对脓毒血症预后评估的临床意义。方法:102例脓毒血症患者按预后分为存活组和死亡组,比较治疗早期MEDS评分、PCT及急性生理与慢性健康状况(APACHEⅡ)评分,并建立ROC曲线观察三者对预后评估的临床价值。结果:两组MEDS评分、PCT和APACHEⅡ评分均有明显差异,且MEDS评分、PCT与APACHEⅡ评分存在明显相关;MEDS评分和PCT预测死亡的ROC曲线下面积分别为0.85和0.78,MEDS的敏感性和特异性分别为80.6%和86.7%,PCT的敏感性和特异性分别为82.3%和78.4%,MEDS评分对脓毒血症预后的评估特异性优于PCT、敏感性逊于PCT;两种联合应用敏感性及特异性更高(86.3%、89.9%)。结论:MEDS评分和PCT对脓毒血症患者预后有较好的预测作用,联合使用可提高敏感性及特异性。
Objective: To investigate the clinical significance of assessing the risk of sepsis in emergencies (MEDS) and prognosis of sepsis with serum procalcitonin (PCT). Methods: 102 patients with sepsis were divided into survival group and death group according to prognosis. MEDS score, PCT and acute physiology and chronic health status (APACHEⅡ) score were compared between the two groups. ROC curves were also established to evaluate the prognosis of the patients value. Results: The scores of MEDS, PCT and APACHEⅡwere significantly different between the two groups, and there was a significant correlation between MEDS score and PCT and APACHEⅡscore. The area under the ROC curve of MEDS score and PCT predicted death were 0.85 and 0.78 respectively, the sensitivity of MEDS and The specificity and specificity were 80.6% and 86.7% respectively. The sensitivity and specificity of PCT were 82.3% and 78.4% respectively. The specificity of MEDS score in predicting the prognosis of sepsis was better than that of PCT and the sensitivity was inferior to PCT. Sensitivity and specificity of the application of higher (86.3%, 89.9%). Conclusion: The MEDS score and PCT predict the prognosis of patients with sepsis better. Combined use can improve the sensitivity and specificity.