血清PCT、CRP、WBC在脓毒症患者病情及预后评估中的应用价值
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摘要
目的探讨血清降钙素原(PCT)、C-反应蛋白(CRP)、白细胞计数(WBC)在脓毒症患者病情及预后评估中的应用价值。方法选择2016年1月~2017年12月我院收治的116例脓毒症患者作为研究对象,其中77例脓毒症(脓毒症组),21例严重脓毒症(严重脓毒症组),18例脓毒性休克(脓毒性休克组)。观察比较三组血清PCT、CRP、WBC水平、患者入院治疗2周后的生存状况及各指标水平,分析三组血清PCT与CRP、WBC水平之间的关系。结果三组的PCT、CRP和WBC水平比较,差异有统计学意义(P<0.01);随着脓毒症病情的加重,患者的PCT、CRP和WBC水平均明显升高(P<0.01)。经2周治疗后,有83例病情好转,25例无效,8例死亡。其中死亡组的PCT、CRP和WBC水平均显著高于无效组和好转组,且无效组的PCT、CRP和WBC水平明显高于好转组(P<0.01)。Pearson相关性分析结果显示:患者血清CRP及WBC均和PCT成正相关(r>0,P<0.01),且CRP与PCT的相关性>WBC。结论血清PCT、CRP和WBC水平与脓毒症患者病情严重程度密切相关,其水平越高,患者病情越严重,预后也越差,且CRP和PCT的评估水平优于WBC。
Objective To explore the value of serum procalcitonin(PCT), C-reactive protein(CRP) and white blood cell count(WBC) in the evaluation of the condition and prognosis of sepsis patients. Methods One hundred and sixteen patients with sepsis admitted to our hospital from January 2016 to December 2017 were selected. Among them, they were further divided into sepsis group(n=77), severe sepsis group(n=21), and septic shock group(n=18). The serum levels of PCT, CRP, and WBC, band the survival status of the patients after 2 weeks of hospitalization and the corresponding indexes in the three groups were observed and compared. The correlations between serum PCT and CRP, and PCT and WBC were analyzed. Results The levels of PCT, CRP and WBC in the three groups were significantly different(P <0.01). As the severity of sepsis increased, the levels of PCT, CRP, and WBC increased significantly(P<0.01). After 2-week treatment, 83 patients improved their conditions, 25 cases were invalid, and 8 cases died. The PCT, CRP, and WBC levels in the death cases were significantly higher than those in the invalid and improved cases. The PCT, CRP,and WBC levels in invalid cases were significantly higher than those in the improved cases(P<0.01). The Pearson correlation analysis showed that serum CRP and WBC were both positively correlated with PCT(r>0, P<0.01), and the correlation between CRP and PCT was greater than that between WBC and PCT. Conclusion Serum PCT, CRP and WBC levels are all closely related to the severity of sepsis. The higher the levels, the more severe the patient′s condition is, and the worse the prognosis is. The evaluation level of CRP and PCT is better than that of WBC.
Objective To explore the value of serum procalcitonin(PCT), C-reactive protein(CRP) and white blood cell count(WBC) in the evaluation of the condition and prognosis of sepsis patients. Methods One hundred and sixteen patients with sepsis admitted to our hospital from January 2016 to December 2017 were selected. Among them, they were further divided into sepsis group(n=77), severe sepsis group(n=21), and septic shock group(n=18). The serum levels of PCT, CRP, and WBC, band the survival status of the patients after 2 weeks of hospitalization and the corresponding indexes in the three groups were observed and compared. The correlations between serum PCT and CRP, and PCT and WBC were analyzed. Results The levels of PCT, CRP and WBC in the three groups were significantly different(P <0.01). As the severity of sepsis increased, the levels of PCT, CRP, and WBC increased significantly(P<0.01). After 2-week treatment, 83 patients improved their conditions, 25 cases were invalid, and 8 cases died. The PCT, CRP, and WBC levels in the death cases were significantly higher than those in the invalid and improved cases. The PCT, CRP,and WBC levels in invalid cases were significantly higher than those in the improved cases(P<0.01). The Pearson correlation analysis showed that serum CRP and WBC were both positively correlated with PCT(r>0, P<0.01), and the correlation between CRP and PCT was greater than that between WBC and PCT. Conclusion Serum PCT, CRP and WBC levels are all closely related to the severity of sepsis. The higher the levels, the more severe the patient′s condition is, and the worse the prognosis is. The evaluation level of CRP and PCT is better than that of WBC.
引文
[1]李沫,李有强,邓光远,等.降钙素原、超敏C反应蛋白与APACHEⅡ对脓毒症预后的评估[J].中国热带医学,2016,16(7):702-704.
[2]王胜云,陈德昌.降钙素原和C-反应蛋白与脓毒症患者病情严重程度评分的相关性研究及其对预后的评估价值[J].中国危重病急救医学,2015,27(2):97-101.
[3]季娟娟,孙耕耘.降钙素原和常用炎症指标在脓毒症诊断及预后中的价值[J].中华肺部疾病杂志(电子版)2015,8(4):4-8.
[4]陈永健,王毓.联合肝素结合蛋白和降钙素原诊断脓毒症及分级的临床应用价值[J].浙江医学,2016,38(20):1671-1674.
[5]陈斌,钟羽,陈祺棠.降钙素原与C反应蛋白联合检测在脓毒症患儿预后评估中的价值研究[J].现代诊断与治疗,2017,28(21):4013-4014.
[6]马颖,季萍,张朝霞,等.降钙素原与超敏C-反应蛋白和N末端前体脑钠肽对脓毒症预后的评估价值[J].中华医院感染学杂志,2016,26(10):2245-2247.
[7]章晋辉,赵群,邹圣强.降钙素原、C-反应蛋白、白细胞计数在脓毒症患者预后评估中的作用[J].中国医药导报,2016,13(13):32-35.
[8]王志文,刘占利,林争,等.脓毒症血流感染患儿血清C-反应蛋白、降钙素原水平变化及临床诊断分析[J].中华医院感染学杂志,2017,27(4):919-922.
[9]谭德敏,谭孟源,陈军,等.脓毒症患者血清降钙素原的表达及其对预后的影响研究[J].中国全科医学,2017,20(5):520-525.
[10]李佳,杜艳雪,刘晓婷,等.血清降钙素原对细菌性脓毒血症患者生存状况的预测研究[J].中华医院感染学杂志,2015,25(24):5534-5536.
[11]张怡,宗媛,牛丹,等.血清PCT、CRP及内毒素在细菌性血流感染所致脓毒症患者中的早期诊断价值[J].河北医学,2016,22(5):768-771.
[12]刘端绘.血液中炎性指标与脓毒症细菌感染患者病情的关系研究[J].临床急诊杂志,2016,17(8):647-649.
[13]孙萍,王东强,刘伟.脓毒症患者白细胞计数及血清降钙素原和C一反应蛋白的动态变化[J].中华危重病急救医学,2014,26(7):516-518.
[14]韦广莹,卢荣恒,李晶.血清超敏C反应蛋白、血清样淀粉酶A与降钙素原对脓毒症患者的预测价值[J].中华危重症医学杂志,2015,8(4):235-240.
[2]王胜云,陈德昌.降钙素原和C-反应蛋白与脓毒症患者病情严重程度评分的相关性研究及其对预后的评估价值[J].中国危重病急救医学,2015,27(2):97-101.
[3]季娟娟,孙耕耘.降钙素原和常用炎症指标在脓毒症诊断及预后中的价值[J].中华肺部疾病杂志(电子版)2015,8(4):4-8.
[4]陈永健,王毓.联合肝素结合蛋白和降钙素原诊断脓毒症及分级的临床应用价值[J].浙江医学,2016,38(20):1671-1674.
[5]陈斌,钟羽,陈祺棠.降钙素原与C反应蛋白联合检测在脓毒症患儿预后评估中的价值研究[J].现代诊断与治疗,2017,28(21):4013-4014.
[6]马颖,季萍,张朝霞,等.降钙素原与超敏C-反应蛋白和N末端前体脑钠肽对脓毒症预后的评估价值[J].中华医院感染学杂志,2016,26(10):2245-2247.
[7]章晋辉,赵群,邹圣强.降钙素原、C-反应蛋白、白细胞计数在脓毒症患者预后评估中的作用[J].中国医药导报,2016,13(13):32-35.
[8]王志文,刘占利,林争,等.脓毒症血流感染患儿血清C-反应蛋白、降钙素原水平变化及临床诊断分析[J].中华医院感染学杂志,2017,27(4):919-922.
[9]谭德敏,谭孟源,陈军,等.脓毒症患者血清降钙素原的表达及其对预后的影响研究[J].中国全科医学,2017,20(5):520-525.
[10]李佳,杜艳雪,刘晓婷,等.血清降钙素原对细菌性脓毒血症患者生存状况的预测研究[J].中华医院感染学杂志,2015,25(24):5534-5536.
[11]张怡,宗媛,牛丹,等.血清PCT、CRP及内毒素在细菌性血流感染所致脓毒症患者中的早期诊断价值[J].河北医学,2016,22(5):768-771.
[12]刘端绘.血液中炎性指标与脓毒症细菌感染患者病情的关系研究[J].临床急诊杂志,2016,17(8):647-649.
[13]孙萍,王东强,刘伟.脓毒症患者白细胞计数及血清降钙素原和C一反应蛋白的动态变化[J].中华危重病急救医学,2014,26(7):516-518.
[14]韦广莹,卢荣恒,李晶.血清超敏C反应蛋白、血清样淀粉酶A与降钙素原对脓毒症患者的预测价值[J].中华危重症医学杂志,2015,8(4):235-240.