降钙素原、新蝶呤与乳酸对脓毒血症患者预后评估研究

目的分析降钙素原、新喋呤与乳酸对脓毒血症患者预后评估的临床价值。方法按预后将95例脓毒血症患者分成生存组和死亡组,其中生存组65例,死亡组30例,将发病早期的降钙素原、新喋呤与乳酸水平和ACHEⅡ评分进行对比,通过建立ROC曲线探讨标记物对于预后评估的临床意义。结果分析得知3种标记物水平和APACHEⅡ评分在2组患者中差异均具有统计学意义(P0.05),并且3种标记物水平与APACHEⅡ评分具有明显的相关性;标记物阳性结果越多,病死率越高;3项标记物预测死亡的ROC曲线下面积在0.70~0.78之间。结论降钙素原、新喋呤与乳酸对脓毒血症患者的预后评估具有重要的临床研究价值,对患者的死亡具有较好的预测意义,并且联合检测能够提高预测的敏感程度。

Value of detection of procalcitonin,neopterin and lactic acid in assessment of prognosis of septic patients

Objective To assess the value of detection of procalcitonin, neopterin and lactic acid in prognosis of septic patients. Methods The 95 cases of septic patients were randomly divided into survival group（65 cases） and death group （30 cases） . The levels of early procalcitonin, neopterin ,lactic acid and APACHE Ⅱ ratings were compared to assess the clinical significance of markers in prognostic assessment through the establishment of the ROC curve. Results The level and APACHE Ⅱ score of three kinds of markers showed a significant difference between the two groups of patients, and three kinds of markers and APACHE Ⅱ score were significantly correlated and the higher of the positive rate of the markers, the higher mortality would be. The ROC area of three markers predicting the death were in the range of 0.70 to 0.78. Conclusion The detection of procalcitonin, neopterin and lactic acid is valuable in assessment of prognosis of septic patients and especially in predicting the death the patients and joint detection can improve the sensitivity of prediction.