降钙素原及内毒素对腹腔感染脓毒症患者预后的评估

目的：探讨降钙素原（procalcitonin，PCT）及内毒素对于腹腔感染脓毒症患者预后的评估价值。方法回顾性分析腹腔感染脓毒症86例的临床资料，根据预后（存活和死亡）和病情严重程度（局部感染、脓毒症、严重脓毒症及脓毒症休克）分组，比较不同组别之间的PCT及内毒素水平，比较PCT和内毒素同急性生理和慢性健康状况评分Ⅱ（ acute physiology and chronic health evaluation Ⅱ，APACHE Ⅱ）和脓毒症相关器官功能障碍评分（ sepsis-related organ failure assessment score ，SO-FA）的相关性，并比较PCT、内毒素和两个临床评分系统对于患者预后的评估价值。结果根据不同评分及预后分组，各组之间PCT水平差异具有统计学意义，而内毒素水平差异无统计学意义。 PCT与两个评分系统具有很好的相关性，而内毒素与评分系统无显著相关。 PCT、内毒素、APACHE Ⅱ和SOFA评分对于预后的受试者工作特征曲线（ ROC 曲线）下面积分别为85.7％、56．3％、86．7％和86.0％。结论 PCT较内毒素能更好地评价腹腔感染脓毒症患者的预后。

Prognostic value of procalcitonin and endotoxin concentrations for intra-abdominal sepsis

Objective To evaluate the value of serum procalcitonin and endotoxin concentrations in prognosis of intra -abdom-inal sepsis.Methods A total of 86 patients with intra-abdominal sepsis were included into the study .We compared PCT and endotoxin concentrations according to classification of different outcomes （ survivors and nonsurvivors ） and intra-abdominal sepsis （ local infec-tions,sepsis,severe sepsis and septic shock ）.The correlation of PCT or endotoxin concentrations to APACHE Ⅱ or SOFA score were also analyzed ,then see their function in judging the prognosis of sepsis .Results Nonsurvivors had a higher level of PCT than survi-vors.PCT concentrations was higher in patients with severe sepsis and septic shock than that with sepsis or local infections .PCT concen-trations was associated with APACHE Ⅱand SOFA score significantly ,but not endotoxin .The area under ROC curve for predicting 28-days mortality of PCT,endotoxin,APACHEⅡand SOFA score were 85.7%,56.3%,86.7%and 86.0%,respectively.Conclusion PCT had a higher prognostic value in intra-abdominal sepsis than endotoxin .