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目的探讨炎性指标与脓毒症患者病情和预后的相关性。方法回顾性分析87例脓毒症患者的临床资料。根据血培养结果分为血行感染组27例和非血行感染组60例。根据病情分为脓毒症组24例、严重脓毒症组28例、脓毒性休克组35例。检测的炎性指标包括降钙素原(PCT)、C反应蛋白(CRP)、WBC和中性粒细胞(NE),比较其在不同疾病严重程度、感染部位、急性生理与慢性健康Ⅱ(APACHEⅡ)评分及预后的差异。绘制ROC曲线,评价PCT对脓毒症的诊断价值。结果血行感染组的PCT水平高于非血行感染组(6.1ng/ml vs.2.4ng/ml)(P<0.05)。ROC曲线分析显示,PCT对血行感染组患者病情评估有较高的价值(AUC=0.654,P<0.05)。脓毒性休克组PCT、CRP、WBC、NE和APACHEⅡ评分高于脓毒症组(P<0.01或P<0.05)。PCT和WBC与APACHEⅡ评分呈正相关(r=0.35和0.27,P<0.05)。结论与其他炎性指标比较,PCT对血行感染脓毒症患者具有较高的病情评估价值。
Objective To investigate the relationship between inflammatory markers and the prognosis of patients with sepsis. Methods The clinical data of 87 sepsis patients were retrospectively analyzed. According to the results of blood culture, there were 27 cases of bloodstream infection and 60 cases of non-bloodstream infection. According to the disease, 24 cases were divided into sepsis group, 28 cases of severe sepsis group and 35 cases of septic shock group. Inflammatory markers detected included procalcitonin, CRP, WBC and neutrophil (NE), and compared their effects on severity of disease, location of infection, acute physiology and chronic health Ⅱ ) Score and prognosis. ROC curve was drawn to evaluate the diagnostic value of PCT in sepsis. Results The level of PCT in bloodstream infection group was higher than that in non-bloodstream infection group (6.1ng / ml vs.2.4ng / ml) (P <0.05). ROC curve analysis showed that PCT had a higher value of disease evaluation in patients with bloodstream infection (AUC = 0.654, P <0.05). The scores of PCT, CRP, WBC, NE and APACHEⅡ in septic shock group were higher than those in sepsis group (P <0.01 or P <0.05). PCT and WBC were positively correlated with APACHE II score (r = 0.35 and 0.27, P <0.05). Conclusion Compared with other inflammatory markers, PCT has a higher disease evaluation value in sepsis patients with blood-borne infection.