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目的探讨降钙素原(PCT)在重症肺炎并发弥散性血管内凝血(DIC)诊断中的作用。方法选取惠州市第一人民医院呼吸内科重症肺炎患者79例,根据是否合并弥散性血管内凝血将患者分为研究组(合并DIC,DIC评分≥5分)和对照组(未合并DIC,DIC评分<5分),采用酶联免疫荧光法测定血清PCT水平,比较两组血清PCT水平和DIC评分,分析血清PCT水平与重症肺炎并发DIC及其凝血指标的关系。结果研究组血清PCT水平和DIC评分均明显高于对照组,两组比较差异有统计学意义(P<0.05);血清PCT<2.0 ng/ml重症肺炎患者DIC并发症发生率为12.66%(10/79),血清PCT≥2.0 ng/ml重症肺炎患者DIC并发症发生率为37.97%(30/79),两者比较差异有统计学意义(P<0.01)。经Pearson相关性分析显示,血清PCT水平与外周血血小板计数、D-二聚体呈明显的正相关(r=0.512,P<0.05;r=0.496,P<0.05)。结论血清PCT水平在重症肺炎并发弥散性血管内凝血患者中显著增高,可能通过影响重症肺炎凝血功能参与DIC发生和发展的过程。
Objective To investigate the role of procalcitonin (PCT) in the diagnosis of severe pneumonia complicated with disseminated intravascular coagulation (DIC). Methods Seventy-nine patients with severe pneumonia in Huizhou First People’s Hospital were enrolled in this study. Patients were divided into study group (DIC combined with DIC score ≥5) and control group (without DIC, DIC score) according to whether they were complicated with disseminated intravascular coagulation <5). Serum PCT levels were measured by enzyme-linked immunosorbent assay. The serum PCT levels and DIC scores were compared between the two groups. The relationship between serum PCT levels and severe pneumonia complicated with DIC and coagulation parameters was analyzed. Results The levels of serum PCT and DIC in the study group were significantly higher than those in the control group (P <0.05). The incidence of DIC in patients with severe pneumonia with PCT <2.0 ng / ml was 12.66% (10 / 79). The incidence of DIC complication in patients with severe pneumonia with PCT≥2.0 ng / ml was 37.97% (30/79), the difference was statistically significant (P <0.01). Pearson correlation analysis showed that serum PCT levels were positively correlated with peripheral blood platelet count and D-dimer (r = 0.512, P <0.05; r = 0.496, P <0.05). Conclusions The serum PCT level is significantly higher in patients with severe pneumonia complicated with disseminated intravascular coagulation, which may be involved in the occurrence and development of DIC by influencing the coagulation function of severe pneumonia.