血清降钙素原在早期诊断脓毒症中的临床研究

目的 观察危重病人在脓毒症及全身性炎症反应综合征(SIRS)时血清降钙素原(PCT)水平的变化及临床意义。方法 38例入选患者分为脓毒症组和SIRS组,分别采用BRAHMS快速半定量法(PCT-Q)和免疫比浊法测定血清PCT、C-反应蛋白(CRP)浓度,同时比较两组间最高体温(BT)、白细胞计数(WBC计数)及中性粒细胞分类,评价PCT、CRP、WBC计数及中性粒细胞分类、BT在SIRS患者中对脓毒症的诊断价值。结果 RCT在脓毒症组较SIRS组显著升高(x±s分别是2.72±1.07分和1.55±0.76分,P=0.001),两组间CRP、WBC计数及中性粒细胞分类、BT比较无差异,对脓毒症的诊断价值由高到低分别为PCT、CRP、BT、中性粒细胞分类和白细胞计数(AUC分别是0.80、0.64、0.64、0.61、0.43)。结论 PCT可以作为早期诊断脓毒症的可靠指标,其他传统炎症指标在区分感染性与非感染性SIRS中的意义有限。

Diagnostic value of serum procalcitonin as an early indicator of sepsis

Objective To observe the serum procalcitonin(PCT) level with PCT-Q quick test(BRAHMS DIAGNOSTICA GmbH, Berlin)between adult patients with systemic inflammatory response syndrome(SIRS) and sepsis and estimate its clinical value. Meanwhile, to compare PCT with conventional inflammatory marks, such as white blood cell(WBC) count, body temperature(BT), C-reactive protein (CRP). Methods Thirty-eight patients who were enrolled in the study, suffered from sepsis or SIRS within 24 hours and divided into two groups, sepsis group(n=18) and SIRS group(n=20). Serum concentration of PCT and CRP were determined, and WBC count, percentage of neutrophils and maximal BT were also recorded within 24 hs on admission. Results PCT was higher in sepsis group. There was a significant difference between two groups(P=0.001). The conventional inflammatory marks revealed that there was no significant difference between two groups(P>0.05). PCT values were compared with the conventional inflammatory marks. Predictive accuracy for sepsis express as are under the receiver operating characteristic(ROC)curve was 0.80 for PCT, 0.64 for CRP, 0.64 for BT, 0.61 for percentage of neutrophils and 0.43 for WBC count. Conclusion PCT could probably be used as a predictive marker in sepsis in emergency departments.