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血清PCT、IL-6与CRP对严重创伤致脓毒症预后的影响
作者:明颖1  闫妹姝1  刘秋霞2  孙常铭1  刘正蓬1  张秀琴1 
单位:1. 承德医学院附属医院 检验科, 河北 承德 067000;
2. 承德市中心医院 检验科, 河北 承德 067000
关键词:脓毒症 降钙素原 白细胞介素-6 C反应蛋白 预后 
分类号:R631
出版年·卷·期(页码):2019·47·第五期(543-547)
摘要:

目的:研究血清降钙素原(PCT)、白细胞介素-6(IL-6)与C反应蛋白(CRP)对严重创伤致脓毒症预后的影响,为临床诊疗提供依据。方法:回顾性分析承德医学院附属医院2013年11月至2017年5月急诊收入的102例严重创伤致脓毒症患者的临床资料。根据入院后28 d内患者的生存情况分为存活组(57例)和死亡组(45例),另选择50例健康献血者作为对照组。比较3组的炎症指标、肌钙蛋白I(cTnI)、24 h内的急性生理与慢性健康评分(APACHCE-Ⅱ)、24 h内的序贯器官衰竭评估(sequential organ failure assessment,SOFA)评分;并分析炎症指标、cTnI与APACHCE-Ⅱ和SOFA评分的相关性,炎症指标、cTnI对判断脓毒症预后的作用大小。结果:PCT、IL-6、CRP、cTnI水平对照组显著低于存活组、死亡组,3组两两比较,差异均有统计学意义(P<0.01)。APACHCE-Ⅱ、SOFA评分存活组显著低于死亡组,差异均有统计学意义(P<0.01)。PCI、IL-6、CRP、cTnI均与APACHCE-Ⅱ呈正相关,PCI、IL-6、CRP与SOFA评分呈正相关,cTnI与SOFA评分无相关性。评价严重创伤致脓毒症预后的曲线下面积CRP显著大于PCT、IL-6、cTnI,差异均有统计学意义(P<0.05)。结论:PCT、IL-6、CRP能够有效预测严重创伤致脓毒症预后,且CRP的判断价值更大。

Objective:To study the effect of serum procalcitonin (PCT), interleukin-6 (IL-6) and C-reactive protein (CRP) on the prognosis of patients with severe traumatic sepsis, and provide a basis for clinical diagnosis and treatment. Methods:Clinical data of 102 patients with severe trauma-induced sepsis treated in our hospital from November 2013 to May 2017 were retrospectively analyzed, and According to the survival conditions within 28 days after admission, they were divided into survival group with 57 patients and death group with 45 patients. Another 50 healthy blood donors were selected as control group. Inflammatory index, troponin I (cTnI), acute physiology and chronic health scores within 24 hours (APACHCE-Ⅱ), and Sequential Organ Failure Assessment (SOFA) scores within 24 hours were compared between the three groups. The effects of inflammation index, cTnI and APACHCE-Ⅱ, SOFA score, inflammation index and cTnI on the prognosis of patients were analyzed. Results:The PCT, IL-6, CRP, and cTnI in the control group were significantly lower than those in the survival group and the death group, and the differences were statistically significant (P<0.01).The APACHCE-Ⅱ and SOFA scores in the survival group were significantly lower than those in the death group. The differences were statistically significant (P<0.01). PCI, IL-6, CRP and cTnI were positively correlated with APACHCE-Ⅱ; PCI, IL-6 and CRP were positively correlated with SOFA score; cTnI was not correlated with SOFA score. The area under the curve of CRP evaluation for the prognosis of severe trauma-induced sepsis was significantly larger than that of PCT, IL-6 and cTnI, and the difference was statistically significant (P<0.05). Conclusion:PCT, IL-6 and CRP can effectively predict the prognosis of patients with severe trauma-induced sepsis, and the value of CRP judgment is greater.

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