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目的研究多发伤患者伤后血清降钙素原(PCT)的水平变化,并探讨其与创伤严重度ISS及危重程度APACHEII评分和脏器功能不全的相关性。方法测定26例多发伤患者伤后24 h内的PCT水平,同时评定ISS、APACHEII分值及脏器功能不全的发生情况和死亡率。在此基础上进行统计分析,了解PCT水平变化及其与脏器功能不全和死亡率的相关性。结果(1)以ISS≤16为分组界限,多发伤患者两组之间PCT值比较,Z=-2.129,P=0.042,差异具有统计学意义。(2)以APACHEII≤20为分组界限,多发伤患者两组之间PCT值比较,Z=-2.117,P=0.034,差异具有统计学意义。(3)以是否发生脏器功能不全为分组标准,两组之间PCT值比较,Z=- 3.089,P=0.002,差异具有统计学意义。(4)以死亡或存活为分组标准,两组之间PCT值比较,Z =-1.307,P=0.191,差异无统计学意义。(5)创伤后24 h内的PCT水平与ISS评分、死亡或存活相关性无统计学意义(P>0.05),与APACHEII评分相关(P=0.033),与OD相关(P= 0.001)。(6)是否发生脏器功能不全,两组之间PCT值比较,差异具有统计学意义(x~2=14.282,P<0.01);当PCT≥10 ng/ml时,脏器功能不全发生率明显增加(x~2=12.831,P<0.01)。结论伤后24 h内的PCT水平与APACHEII、脏器功能不全发生率密切相关,当PCT≥10 ng/ml时,脏器功能不全发生率明显增加。
Objective To study the changes of serum procalcitonin (PCT) levels in patients with multiple traumatic injuries and to explore the correlation between the levels of traumatic severity of ISS and the severity of APACHEII score and organ dysfunction. Methods Twenty-six patients with multiple traumatic injuries were enrolled in this study. The PCT levels within 24 hours after injury were evaluated. The scores of ISS, APACHEII, organ dysfunction and mortality were also evaluated. On this basis, statistical analysis was conducted to find out the correlation between PCT level changes and organ dysfunction and mortality. Results (1) ISS ≤ 16 for the group boundaries, multiple trauma patients PCT values between the two groups, Z = -2.129, P = 0.042, the difference was statistically significant. (2) The APACHEII≤20 for the group boundaries, multiple trauma patients PCT values between the two groups, Z = -2.117, P = 0.034, the difference was statistically significant. (3) According to whether organ dysfunction was the group standard, the PCT values between the two groups were compared, Z = - 3.089, P = 0.002, the difference was statistically significant. (4) The death or survival as the group standard, PCT values between the two groups, Z = -1.307, P = 0.191, the difference was not statistically significant. (5) There was no significant correlation between PCT level and ISS score, death or survival within 24 hours after trauma (P> 0.05), APACHEII score (P = 0.033) and OD (P = 0.001). (6) Whether organ dysfunction occurred, the PCT value between the two groups was statistically significant (x ~ 2 = 14.282, P <0.01); when PCT≥10 ng / ml, the incidence of organ dysfunction Significantly increased (x ~ 2 = 12.831, P <0.01). Conclusions The PCT level within 24 h after injury is closely related to the incidence of APACHEII and organ dysfunction. When PCT≥10 ng / ml, the incidence of organ dysfunction is significantly increased.