本文選題：降鈣素原 + 膿毒癥��； 參考：《中國(guó)全科醫(yī)學(xué)》2017年S1期

【摘要】：目的對(duì)ICU膿毒癥患者的血清降鈣素原水平進(jìn)行實(shí)時(shí)動(dòng)態(tài)監(jiān)測(cè),探索動(dòng)態(tài)監(jiān)測(cè)血清降鈣素原在評(píng)估ICU膿毒癥患者預(yù)后與嚴(yán)重程度中的應(yīng)用價(jià)值。方法選取2012年12月—2015年12月在本院ICU病房進(jìn)行觀(guān)察與治療的100例膿毒癥患者,分別為一般膿毒癥組、嚴(yán)重膿毒癥組、膿毒性休克組。對(duì)各組患者血清降鈣素原水平進(jìn)行為期1周的動(dòng)態(tài)監(jiān)測(cè),通過(guò)急性生理學(xué)及慢性健康狀況評(píng)分系統(tǒng)(APACHⅡ)評(píng)分判斷3組患者入院當(dāng)天癥狀嚴(yán)重程度,并統(tǒng)計(jì)30 d內(nèi)患者的死亡率;結(jié)合ROC曲線(xiàn)評(píng)價(jià)血清降鈣素原在評(píng)估膿毒癥的預(yù)后與嚴(yán)重程度中的價(jià)值。結(jié)果患者痰細(xì)菌陽(yáng)性培養(yǎng)率為42.0%。3組患者入院當(dāng)天APACHⅡ評(píng)分比較,差異有統(tǒng)計(jì)學(xué)意義(P0.05);兩兩比較顯示,一般膿毒癥組與其余兩組差異有統(tǒng)計(jì)學(xué)意義(P0.05),嚴(yán)重膿毒癥組與膿毒性休克組差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。3組患者30 d內(nèi)死亡率比較,差異有統(tǒng)計(jì)學(xué)意義(P0.05);兩兩比較差異均有統(tǒng)計(jì)學(xué)意義(P0.05)。一般膿毒癥組、嚴(yán)重膿毒癥組、膿毒性休克組3組患者在入院第1、2、3、4天的血清降鈣素原水平兩兩比較,差異有統(tǒng)計(jì)學(xué)意義,膿毒性休克組血清降鈣素原水平高于其他兩組(P0.05);入院第5、6、7天差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。入院第1天血清降鈣素原水平對(duì)于膿毒癥的診斷價(jià)值切點(diǎn)為6.68 ng/ml時(shí),AUC為0.964,95%CI為(0.644,0.989),靈敏度為93.54%,特異度為73.96%。結(jié)論在評(píng)估膿毒癥患者預(yù)后與嚴(yán)重程度的過(guò)程中,對(duì)ICU膿毒癥患者血清降鈣素原進(jìn)行實(shí)時(shí)動(dòng)態(tài)監(jiān)測(cè)有較為明確的價(jià)值,可作為重要指標(biāo)評(píng)價(jià)膿毒癥患者預(yù)后與嚴(yán)重程度。
[Abstract]:Objective to investigate the value of real-time dynamic monitoring of serum procalcitonin level in patients with sepsis in ICU and to evaluate the prognosis and severity of sepsis in ICU. Methods 100 patients with sepsis who were observed and treated in ICU from December 2012 to December 2015 were divided into general sepsis group, severe sepsis group and septic shock group. The serum procalcitonin level in each group was monitored dynamically for one week. The severity of symptoms on the day of admission was judged by acute physiology and chronic health status scoring system (APACH 鈪，

本文編號(hào)：2102720