血清降钙素原对烧伤脓毒症患者预后的临床意义

目的:探讨血清降钙素原(procalcitonin,PCT)对烧伤脓毒症患者预后的临床意义。方法:将46例烧伤脓毒症患者根据预后情况分为存活组27例与死亡组19例。46例烧伤脓毒症患者在确诊为脓毒症时及确诊后的第1、3、5、7、9天检测血清PCT和Hs-CRP及进行急性生理学及慢性健康状况评分(APACHEⅡ评分)。在烧伤脓毒症确诊时绘制46例患者血清PCT值的受试者工作特征(ROC)曲线,分析其对死亡的预测效果。结果:死亡组血清PCT在确诊脓毒症时及确诊后的第1、3、5、7、9天一直维持较高的水平,存活组血清PCT下降,且死亡组均高于存活组(P<0.05);死亡组Hs-CRP和APACHEⅡ评分在确诊脓毒症时及确诊后的第1天与生存组比较差异无显著性(P>0.05);死亡组Hs-CRP和APACHEⅡ评分在确诊脓毒症后的第3、5、7、9天高于生存组(P<0.05)。46例烧伤脓毒症患者的血清PCT水平对死亡预测的ROC曲线下总面积为0.931,11.23 ng/m L为血清PCT的最佳阈值,灵敏度为90.6%,特异性度为100%。结论:血清PCT值可作为烧伤脓毒症患者预后判断指标,为后期临床治疗提供依据,降低病死率。

The prognostic clinical significance of serum procalcitonin in patients with burn sepsis

Objective:To explore the prognostic clinical significance of serum procalcitonin(PCT) in patients with burn sepsis.Methods:According to the outcome 46 cases of patients with burn sepsis were divided into two groups:survival group (n =27) and death group(n =19).46 cases of patients with burn sepsis were detected serum PCT and Hs-CRP and conducted acute physiology and chronic health evaluation (APACHE Ⅱ score) when sepsis was diagnosed and confirmed after 1,3,5,7 and 9d.Receiver operating characteristic(ROC) curve of serum PCT value was used to predict death for 46 burn patients when sepsis was diagnosed.Results:Death group serum PCT in the diagnosis of sepsis and confirmed after 1,3,5,7,9 d has maintained high level,survival group serum PCT decreased.Serum PCT of death group were higher than survival group (P ＜ 0.05).There were no statistically significant differences in Hs-CRP and APACHE Ⅱ score between death group and survival group when when sepsis was diagnosed and post sepsis day(P ＞ 0.05),When sepsis was diagnosed and confirmed after 3,5,7 and 9d the Hs-CRP and APACHE Ⅱ score of death group were higher than survival group(P ＜ 0.05).The total area under ROC curve of serum PCT value for predicting death for 46 patients with burn sepsis was 0.931 and 11.23 ng/mL was chosen as the optimal threshold value with with sensitivity of 90.6％ and specificity of 100％.Conclusion:Serum PCT value can be served as a vital prognostic indicator for patients with burn sepsis and provide the basis for clinical treatment,in order to reduce mortality.