唐钟祥;黄顺伟;陈娟;蔡常洁;管向东;

• 1:中山大学附属第一医院SICU

摘要(Abstract)：

目的探讨SICU严重脓毒症患者降钙素原与APCHEII评分以及预后的关系。方法回顾性分析2012年12月至2013年12月中山大学附属第一医院SICU住院的严重脓毒症患者64例,记录患者入SICU的第1、3、7天PCT、超敏C-反应蛋白(CRP)、生命体征、血常规等指标,并计算急性生理与慢性健康状况(APACHEII)评分,建立ROC曲线观察PCT及APACHEII对预后评估的临床价值。结果 64例患者死亡33例(死亡组),存活31例(存活组);死亡组第1、3、7天血清PCT水平(78.49±193.77)ng/m L、(61.55±176.70)ng/m L、(61.68±197.89)ng/m L高于存活组(10.70±15.44)ng/m L、(10.60±21.80)ng/m L、(5.67±8.94)ng/m L,P<0.05;死亡组第1天APACHE II评分(21.15±6.93)高于存活组第1天(18.06±5.40),P<0.05。PCT与APACHEII存在相关性。入ICU第一天PCT水平和APACHEII评分预测死亡的ROC曲线下面积分别为0.625(95%CI 0.49-0.76)和0.623(95%CI 0.49-0.78)。结论严重脓毒症患者入ICU第一天PCT水平判断预后与APACHEII评分相当。

关键词(KeyWords)： 严重脓毒症;ICU;降钙素原

Abstract:

Keywords:

基金项目(Foundation):

作者(Authors): 唐钟祥;黄顺伟;陈娟;蔡常洁;管向东;

DOI: 10.13799/j.cnki.mdjyxyxb.2015.03.007

参考文献(References)：

• [1]Venkataraman R,Kellum JA.Sepsis:update in the management[J].Adv Chronic Kidney Dis,2013,20(1):6-13.
• [2]Nunes AC,Romaozinho JM,Pontes JM,et a1.Risk factors for stricture development after caustic ingestion[J].Hepatogastroenterology,2012,59:1563-1566.
• [3]DellingerRP,Levy MM,Rhodes A,etal.Survivingsepsis campaign:international guidelines for management of severe sepsis and septic shock:2012[J].Crit Care Med,2013,41(2):580-637.
• [4]Guven H,Aldntop L,Baydin A,et al.Diagnosticvalue of proealeitonin levels an early indicator of sepsis[J].Am J Emerg Med,2002,20(3):202-206.
• [5]Levy MM,Fink MP,Marshall JC,et al.2001 Sc CWEs ICM/ACCP/ATS/SIS international sepsis definitions conference[J].Cfif Care Med,2003,31(4):1250-1256.
• [6]Assicot M,Gendrel D,Carsin H,et al.High serum Procalcitonin concentrations in Patients with se Psis and infection[J].Lancet,1993,341(8844):515-518.
• [7]郑怡麟,何莹,陈安,等.抗人降钙素原特异性单克隆抗体的制备鉴定及初步应用[J].第三军医大学学报,2013,35:523-526.
• [8]熊明洁,范红,郭靓.80例脓毒血症患者血清降钙素原监测和预后评估的临床研究[J].重庆医学,2011,40(30):3076-3078.
• [9]蒋贤高,汪晓波,王仁数.脓毒血症患者监测血清降钙素原、C反应蛋白的临床意义[J].中国呼吸与危重症杂志,2009,8(5):429-431.
• [10]Harbarth S,Holeckova K Froidevaux C,et a1.Diagnostic value of procalcitonin,interleukin-6,and interleukin-8 in critically ill patients admitted with suspected sepsis[J].Am J Respir Crit Care Med,2001,164:396-402.
• [11]Pieri G,Agarwal B,Burroughs AK.C-reactive protein and bacterial infection in cirrhosis[J].Ann Gastroenterol,2014,27(2):113-120.
• [12]Ciriello V,Gudipati S,Stavrou PZ,et al.Biomarkers predicting sepsis in polytrauma patients:current evidence[J].Injury,2013,44(12):1680-1692.
• [13]Shigeki Kushimoto,Yasushi Slliba,Yui Koido.The clinical usefulness of procalcitonin measurement for assessing the severity of bacterial infection in ritically ill patients requiring corticosteroid therapy[J].Nippon Med Sch,2007,74(3):236·240.
• [14]Femando A Bozza,Jorge I Salluh,Andrd M Japiassu,et al.Cytokine profiles as markers of disease sevedty in sepsis:a multiplex analysis[J].Crit Care Med,2007,ll(2):1-8.
• [15]Guclu E,Durmaz Y,Karabay O.Effect of severe sepsis on platelet count and their indices[J].Afr Health Sci,2013,13:333-338.
• [16]Al Tehewy M,El Houssinie M,El Ezz NA,et al.Developing severity adjusted quality measures for intensive care units[J].Int J Health Care Qual Assur,2010,23(3):277-286.