降钙素原、C反应蛋白清除率对脓毒性休克患者的预后价值

余长升; 马艳红; 辛晓婷

doi:10.13201/j.issn.1009-5918.2020.06.013

降钙素原、C反应蛋白清除率对脓毒性休克患者的预后价值

- 青海省第五人民医院重症监护室(西宁, 810000)

详细信息

通讯作者: 余长升,E-mail:380655092@qq.com

中图分类号: R631.2

收稿日期: 2020-01-15

Prognostic value of procalcitonin and C-reactive protein clearance rate in septic shock patients

- Intensive Care Unit, the Fifth People's Hospital of Qinghai Province, Xining, 810000, China

More Information

Corresponding author: YU Changsheng, E-mail: 380655092@qq.com

Received Date: 15 January 2020

摘要

摘要: 目的:探讨降钙素原清除率(PCT-c)、C反应蛋白清除率(CRP-c)在脓毒性休克患者28 d内病死率的价值。方法:选取我院在2016-01—2019-02期间收治的223例脓毒性休克患者,根据28 d内的死亡事件分为生存组(165例)与死亡组(58例)。采用酶联荧光法测定血清PCT浓度,采用免疫比浊法测定血清CRP浓度。之后在第2天、第3天、第5天以同样方式测定血清PCT及CRP浓度。计算PCT-c2/1、PCT-c3/1、PCT-c5/1、CRP-c2/1、CRP-c3/1、CRP-c5/1。结果:脓毒性休克患者病死率为26.0%。生存组患者的SOFA评分低于死亡组患者,差异有统计学意义(P<0.05)。死亡组患者第1天、第2天、第3天、第5天的血清PCT及CRP浓度均高于生存组患者,差异有统计学意义(P<0.05)。PCT-c3/1的AUC为0.797,最佳截断值为0.68;CRP-c3/1的AUC为0.802,最佳截断值为0.55。SOFA评分(OR:2.261,95%CI:1.738~2.940)、PCT-c3/1≤0.68(OR:3.544,95%CI:2.324~6.968)及CRP-c3/1≤0.55(OR:3.874,95%CI:1.065~7.099)为脓毒性休克患者死亡的独立危险因素(P<0.05)。结论:PCT-c及CRP-c对于预测28 d内脓毒性休克患者病死率的价值相当且均具有较高的临床价值,建议将其纳入常规的监测指标中,进一步完善该类患者治疗指导方案。
- 脓毒症 /
- 降钙素原 /
- C反应蛋白 /
- 清除率 /
- 死亡
Abstract: Objective: To explore the value of procalcitonin clearance rate(PCT-c) and C-reactive protein clearance rate(CRP-c) in the mortality rate of septic shock within 28 days. Method: Two hundred and twenty-three patients with sepsis complicated with septic shock were selected from January 2016 to February 2019 in our hospital. According to the death events within 28 days, they were divided into survival group and death group. Serum PCT concentration was determined by ELISF and serum CRP concentration was determined by immunoturbidimetry. The serum PCT and CRP levels were measured in the same way on day 2, 3 and 5. PCT-c2/1, PCT-c3/1, PCT-c5/1, CRP-c2/1, CRP-c3/1 and CRP-c5/1 were calculated. Result: There were 165 patients in survival group and 58 patients in death group. The mortality rate was 26.0%. The SOFA score of survival group was lower than that of death group(P<0.05). The serum PCT and CRP levels of the dead group on the first day, the second day, the third day and the fifth day were higher than those of the survival group, and the difference was statistically significant(P<0.05). The AUC of PCT-c3/1 is 0.797, the best truncation value is 0.68, the AUC of CRP-c3/1 is 0.802, and the best truncation value is 0.55. SOFA score(OR: 2.261, 95%CI: 1.738-2.940), PCT-c3/1≤0.68(OR: 3.544, 95%CI: 2.324-6.968) and CRP-c3/1≤0.55(OR: 3.874, 95%CI: 1.065-7.099) were independent risk factors for death in sepsis patients with septic shock(P<0.05).Conclusion: PCT-c and CRP-c have similar and high clinical value in predicting the mortality of septic shock within 28 days. It is suggested that PCT-c and CRP-c should be included in routine monitoring indicators to further improve the treatment guidance program for such patients.
- sepsis /
- procalcitonin /
- C-reactive protein /
- clearance rate /
- death

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