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目的研究分析降钙素原(procalcitonin,PCT)、乳酸清除率(lactate clearance rate,LCR)联合剩余碱(base excess,BE)对感染性休克患者预后的评估价值。方法 108例感染性休克患者作为研究对象,根据存活与否将患者分成存活组58例和死亡组50例,统计比较两组患者入重症监护病房(ICU)治疗后第1、2、3天及出ICU时的PCT、BE,以及患者入ICU治疗后6 h的LCR值。结果入ICU治疗第1天,两组患者的PCT水平比较差异无统计学意义(P>0.05);治疗第2天及往后,存活组PCT水平低于死亡组,并且随着时间的推移,两组差异幅度不断扩大,比较差异具有统计学意义(P<0.05)。存活组患者复苏6 h LCR检测水平为(28.46±5.19)%,显著高于死亡组的(8.96±2.37)%,差异有统计学意义(t=24.449,P<0.05)。入ICU治疗第1天,两组BE水平比较差异无统计学意义(P>0.05);治疗第2天往后,存活组患者的BE指标值不断上升,而死亡组则持续降低,两组比较差异具有统计学意义(P<0.05)。结论 PCT、LCR及BE检测指标数据不仅能够反映出感染性休克患者的病情加重情况,同时也是人体代谢以及全身灌注的指标性数据,三者的联合检测可以作为临床评估感染性休克患者预后情况的重要技术手段,值得应用推广。
Objective To evaluate the prognostic value of procalcitonin (PCT), lactate clearance rate (LCR) and base excess (BE) in patients with septic shock. Methods A total of 108 patients with septic shock were divided into survival group (n = 58) and death group (n = 50) according to the survival or not. Two groups were compared on the first, second and third days after intensive care unit (ICU) PCT, BE at ICU, and LCR at 6 h after ICU treatment. Results There was no significant difference in PCT level between the two groups on the first day after ICU treatment (P> 0.05). On the second day and after the treatment, PCT level in survival group was lower than that in death group, and with the passage of time, The difference between the two groups continued to expand, the difference was statistically significant (P <0.05). The level of LCR in survivors was (28.46 ± 5.19)% at 6 h after resuscitation, which was significantly higher than that in survivals (8.96 ± 2.37)%, the difference was statistically significant (t = 24.449, P <0.05). On the first day after ICU treatment, there was no significant difference in BE levels between the two groups (P> 0.05). On the second day after treatment, the BE index in survivors continued to increase while the death group continued to decrease. The difference was statistically significant (P <0.05). Conclusions The data of PCT, LCR and BE can not only reflect the exacerbation of septic shock but also the index of body metabolism and systemic perfusion. The combined detection of these three indexes can be used as a clinical evaluation of the prognosis of patients with septic shock Important technical means, it is worth to promote.