血清降钙素原与多器官功能障碍综合征严重程度相关性的临床研究

目的 研究血清降钙素原(PCT)水平与多器官功能障碍综合征(MODS)严重程度的相关性。 方法 对61例MODS患者(其中感染组40例,非感染组21例)采用微量双夹心免疫发光法测定血清PCT 水平,并记录其急性生理学与慢性健康状况Ⅱ(APACHE Ⅱ)评分和Marshall评分,采用线性回归分析方法分 析血清PCT水平与APACHEⅡ评分的相关性。结果 MODS患者血清PCT水平呈不同程度升高;感染组血 清PCT13．01(2．73,64．79)μg／L]、APACHEⅡ评分(17．50±5．35)分]与Marshall评分(6．38±2．46)分] 明显高于非感染组(1．50(0,2．98)μg／L、(14．67±3．01)分和(4．62±2．01)分,P<0．05或P<0．0013;感染组 与非感染组血清PCT水平与APACHEⅡ评分不相关(r=0．175,P=0．281;r=0．071,P=0．759),全部 MIDDS患者血清PCT水平与APACHEⅡ评分也无明显相关性(r=0．229,P=0．076);全部MODS患者血清 PCT水平与Marshall评分显著相关(r=0．514,P<0．001),但感染组的r值更高(r=0．535,P<0.001),非感 染组血清PCT水平与Marshall评分不相关(r=0．003,P=0．991)。结论 检测血清PCT对判断感染导致的 MODS患者病情严重程度具有重要的临床价值。

Clinical study of relationship between serum procalcitonin and severity of multiple organ dysfunction syndrome

OBJECTIVE: To study the correlation between serum procalcitonin (PCT) level and severity of multiple organ dysfunction syndrome (MODS). METHODS: Sixty-one patients with MODS were enrolled in this study. They were divided into infection group and non-infection group. Serum PCT were measured using an immunoluminometric assay. Acute physiology and chronic health evaluation II (APACHE II) scores and Marshall scores of the two groups were recorded and the relationship between PCT levels and APACHE II scores as well as Marshall scores was analysed. RESULTS: Serum PCT levels in patients with MODS were higher. Serum PCT 13.01(2.73, 64.79) mug/L], APACHE II (17.50+/-5.35) scores] and Marshall score (6.38+/-2.46) scores] of infection group were significantly higher than non-infection group 1.50 (0, 2.98) microg/L, (14.67+/-3.01) scores, and (4.62+/-2.01) scores, respectively, P<0.05 or P<0.001]. Serum PCT of infection group and non-infection group did not show correlation with APACHE II (r=0.175, P=0.281; r=0.071, P=0.759). Serum PCT of all patients with MODS showed positive correlation with Marshall score (r=0.514, P<0.001), and correlation index of infection group was higher (r=0.535, P<0.001). Serum PCT of non-infection group did not show correlation with Marshall score (r=0.003, P=0.991). CONCLUSION: Serum PCT has clinical values in judgment of the severity of infected patients complicated by MODS.