本文選題：降鈣素原 + 膿毒癥��； 參考：《醫(yī)學(xué)研究生學(xué)報(bào)》2016年07期

【摘要】：目的全身炎癥反應(yīng)綜合征(systemic inflammatory response syndrome,SIRS)可由感染和非感染因素引起,兩者臨床特征相似,但治療和預(yù)后不同,需盡早區(qū)分。降鈣素原(procalcitonin,PCT)在感染時(shí)快速大量合成,可作為早期快速診斷膿毒癥的血清生物標(biāo)志。文中回顧性分析血清PCT水平對(duì)外科ICU病房SIRS患者的病因診斷與預(yù)后價(jià)值。方法選擇2014年6月1日至2015年6月1日期間南京軍區(qū)南京總醫(yī)院外科監(jiān)護(hù)病房166例SIRS患者的數(shù)據(jù)進(jìn)行分析,其中包括患者基本情況、原發(fā)疾病、實(shí)驗(yàn)室結(jié)果及臨床轉(zhuǎn)歸。分析比較血培養(yǎng)結(jié)果、臨床轉(zhuǎn)歸及血清PCT測(cè)定值。結(jié)果 166例SIRS患者中膿毒癥131例,PCT中位數(shù)濃度為2.43(0.81~10.51)ng/m L,其中109例血清PCT陽(yáng)性(≥0.47 ng/m L),陽(yáng)性率為83.2%;非感染性SIRS 35例,PCT中位數(shù)濃度為0.23(0.10~0.39)ng/m L,陽(yáng)性率為17.14%。2組患者血清PCT及陽(yáng)性率比較,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。細(xì)菌和真菌所致膿毒癥患者PCT陽(yáng)性率分別為86.5%(83/96)和74.3%(26/35),中位數(shù)濃度分別為4.28(1.05~14.59)和0.89(0.37~1.59)ng/m L,細(xì)菌感染組顯著高于真菌感染組(P0.05)。膿毒癥死亡和存活患者血清PCT陽(yáng)性率分別為94.4%(34/36)和78.9%(75/95),中位數(shù)濃度分別為12.89(4.76~47.73)和1.41(0.54~4.00)ng/m L,兩者陽(yáng)性率及血清PCT水平比較差異均有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論血清PCT水平可成為區(qū)分膿毒癥和非感染SIRS的重要依據(jù)。細(xì)菌感染膿毒癥患者血清PCT水平明顯高于真菌感染組;膿毒癥死亡組患者血清PCT水平顯著高于存活患者。血清PCT測(cè)定有助于SIRS病因診斷和預(yù)后。
[Abstract]:Objective systemic inflammatory response syndrome (SIRs) can be caused by infection and non-infection. The clinical characteristics of the two are similar, but the treatment and prognosis are different, so it is necessary to distinguish them as soon as possible. Procalcitonin (PCT) is synthesized rapidly and in large quantities during infection, which can be used as a serum biomarker for early diagnosis of sepsis. The value of serum PCT level in etiological diagnosis and prognosis of SIRS patients in surgical ICU ward was analyzed retrospectively. Methods the data of 166 patients with SIRS in surgical ward of Nanjing General Hospital of Nanjing military region from June 1, 2014 to June 1, 2015 were analyzed, including the basic condition of patients, primary diseases, laboratory results and clinical outcome. The results of blood culture, clinical outcome and serum PCT were analyzed and compared. Results the median concentration of SIRS was 2.43(0.81~10.51)ng/m L in 131 patients with sepsis, in which 109 cases were positive for PCT (鈮，

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