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目的探讨恶性肿瘤伴脓毒血症患者的降钙素原(PCT)、白介素6(IL-6)、C-反应蛋白(CRP)、白细胞计数(WBC)和血沉(ESR)等炎症指标及预后。方法选取2016年7月至2017年2月间同济医学院附属同济医院收治的73例恶性肿瘤伴脓毒血症感染患者为观察组,选取同期住院的60例非肿瘤脓毒血症患者为对照组。检测并比较两组患者的PCT、IL-6、CRP、WBC和ESR水平,评估两组患者的急性生理与慢性健康状况评分Ⅱ(APACHEⅡ)和序贯器官衰竭评估(SOFA)状况。结果观察组患者的IL-6、CRP和ESR水平均比对照组患者高,WBC较对照组患者低,差异均有统计学意义(均P<0.05)。但两组患者PCT水平无明显变化,差异无统计学意义(P>0.05)。结论恶性肿瘤伴脓毒血症患者可通过联合检测PCT、IL-6、CRP、WBC和ESR水平判断感染情况,其中PCT不受肿瘤干扰,对早期诊断、指导临床应用抗菌素及评估预后有重要意义。
Objective To investigate the inflammatory markers such as procalcitonin (PCT), interleukin 6 (IL-6), C-reactive protein (CRP), white blood cell count (WBC) and ESR in patients with malignant tumor and sepsis and their prognosis . Methods From July 2016 to February 2017 Tongji Medical College Affiliated Tongji Hospital, 73 cases of malignant tumor with sepsis infection were selected as the observation group. 60 patients with non-tumor sepsis hospitalized in the same period were selected as the control group group. The levels of PCT, IL-6, CRP, WBC and ESR in both groups were detected and compared to evaluate the status of acute physiology and chronic health status Ⅱ (APACHEⅡ) and sequential organ failure assessment (SOFA). Results The levels of IL-6, CRP and ESR in the observation group were significantly higher than those in the control group and lower than those in the control group (all P <0.05). However, there was no significant difference in PCT level between the two groups (P> 0.05). Conclusion The detection of PCT, IL-6, CRP, WBC and ESR levels in patients with malignant tumor and sepsis can be used to determine the infection status. Among them, PCT is not affected by tumor and is of great significance for early diagnosis, clinical application of antibiotics and assessment of prognosis .