外周血降钙素原对感染性休克患者治疗效果的评估价值

目的：探讨外周血降钙素原（ PCT）对感染性休克患者治疗效果的评估价值。方法感染性休克患者80例，分别于确诊后1 d、7 d、14 d测定外周血PCT水平，根据治疗效果将患者分为好转组与恶化组，比较两组不同时间点的PCT水平，采用受试者工作特征（ ROC）曲线分析 PCT 评估感染性休克患者治疗效果的截断值。结果80例感染性休克患者中，42例患者病情好转（好转组），占52．5％；38例病情恶化或死亡（恶化组），占47．5％。各个时间点，恶化组的PCT水平高于好转组（P＜0．05）；随着时间延长，恶化组的PCT水平逐渐升高，好转组的PCT水平逐渐降低（P＜0．05）。在诊断后7 d，PCT评估治疗效果的ROC曲线下面积为0．698，截断值为3．45 ng／ml，灵敏度73．7％，特异度为71．4％；在诊断后14 d， ROC曲线下面积为0．710，截断值为1．05 ng／ml，灵敏度为94．7％，特异度为88．1％。结论 PCT水平可用于评估感染性休克患者的病情变化，在诊断后14 d PCT在较低的水平即可较好地反映患者的病情变化。

Value of peripheral blood procalcitonin applied to evaluating therapeutic efficacy in patients with septic shock

Objective To explore the value of peripheral blood procalcitonin (PCT) applied to evaluating the therapeutic efficacy in the patients with septic shock .Methods A total of 80 patients with septic shock were enrolled .The levels of peripheral blood PCT were detected at 1,7 and 14 days after definite diagnosis .The patients were divided into improvement group and deterioration group according to the therapeutic efficacy .The PCT levels were compared between two groups at different time points .The cutoff value of PCT for evaluating the therapeutic efficacy in the patients with septic shock was assessed by receiver operating characteristic ( ROC) curve.Results Of 80 patients with septic shock,42(52.5%) patients were improved(improvement group),and 38(47.5%) patients deteriorated (deterioration group).The PCT levels at different time points in the improvement group were higher than those in the deterioration group (P<0.05).The PCT level increased in the improvement group but decreased in the deterioration group with the increase of time (P<0.05).At 7 days after diagnosis,the area under ROC curve of PCT for evaluating the therapeutic efficacy was 0.698,the cutoff value was 3.45 ng/ml,and the sensitivity and specificity were 73.7%and 71.4%respectively.At 14 days after diagnosis,the area under ROC curve of PCT for evaluating the therapeutic efficacy was 0.710,the cutoff value was 1.05 ng/ml,and the sensitivity and specificity were 94.7%and 88.1%respectively. Conclusion PCT level can be used to evaluate the disease change of patients with septic shock .And PCT at a low level can reflex the condition changes of the patients at 14 days after diagnosis .