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目的探讨降钙素原(procalcitonin,PCT)监测对脓毒症患者的影响。方法采用回顾性研究方法,选择2014年1月—2015年11月黑龙江省医院的脓毒症患者26例,分为监测PCT组(试验组)和未监测PCT组(对照组),观察两组治疗前后急性生理学与慢性健康状况评分系统Ⅱ(acute physiology and chronic health evaluationⅡ,APACHEⅡ)评分和序贯器官衰竭评分(sequential organ failure assessment,SOFA)等。分析PCT等因素对脓毒症患者预后的影响。两组间比较采用独立样本t检验,组内比较采用配对t检验;计数资料比较采用Fisher确切概率法,P<0.05为差异有统计学意义。结果两组患者治疗后SOFA、APACHEⅡ评分[(5.86±1.89)、(4.15±2.23)分与(17.14±7.42)、(11.32±6.91)分]比较,差异均有统计学意义(均P<0.05)。试验组治疗前后SOFA、APACHEⅡ评分比较,差异均有统计学意义(t=2.444、2.234,均P<0.05)。试验组的生存率为92.31%(12/13),对照组为69.23%(9/13),比较差异有统计学意义(P<0.05)。结论 PCT是确诊细菌感染的金标准,用于监测抗生素疗效,可随时调整抗生素,可判定脓毒症患者的预后,有助于降低脓毒症病死率。
Objective To investigate the effect of procalcitonin (PCT) monitoring on patients with sepsis. Methods A retrospective study was conducted to select 26 patients with sepsis from January 2014 to November 2015 in Heilongjiang Provincial Hospital. The patients were divided into two groups: the monitoring PCT group (experimental group) and the non-monitoring PCT group (control group) The scores of acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) and sequential organ failure assessment (SOFA) before and after treatment. Analysis of PCT and other factors on the prognosis of patients with sepsis. The two groups were compared using independent samples t test, the group was compared using paired t test; count data using Fisher exact test, P <0.05 for the difference was statistically significant. Results After treatment, SOFA and APACHEⅡscores in both groups were significantly different (all P <0.05) compared with those in control group [(5.86 ± 1.89), (4.15 ± 2.23) vs (17.14 ± 7.42), (11.32 ± 6.91) ). Before and after treatment, the scores of SOFA and APACHEⅡ in the experimental group were significantly different (t = 2.444,2.234, all P <0.05). The survival rate of the experimental group was 92.31% (12/13) and that of the control group was 69.23% (9/13), the difference was statistically significant (P <0.05). Conclusion PCT is the gold standard for the diagnosis of bacterial infection. It is used to monitor the efficacy of antibiotics, to adjust the antibiotics at any time, to determine the prognosis of patients with sepsis and to reduce the mortality of sepsis.