| 尹彦芬,容维娜,张 霞,赵国栋,王胜磊,李晓峰,张惠祺,刘月宣.脓毒症患者血清降钙素原、C-反应蛋白与凝血功能、病情评分的关系及预后的影响因素分析[J].,2021,(7):1333-1337 |
| 脓毒症患者血清降钙素原、C-反应蛋白与凝血功能、病情评分的关系及预后的影响因素分析 |
| Analysis of the Relationship between Serum Procalcitonin, C-reactive Protein, Coagulation Function, Disease Score and Prognostic Factors in Patients with Sepsis |
| 投稿时间：2020-07-22 修订日期：2020-08-18 |
| DOI：10.13241/j.cnki.pmb.2021.07.029 |
| 中文关键词: 降钙素原 C-反应蛋白 凝血功能 脓毒症 预后 急性生理功能和慢性健康状况评分系统Ⅱ 序贯器官衰竭估计 |
| 英文关键词: Procalcitonin C-reactive protein Coagulation function Sepsis Prognosis Acute physical and chronic health II score Sequential organ failure assessment |
| 基金项目:河北省医学科学研究重点计划项目（20181022） |
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| 中文摘要: |
| 摘要 目的：探讨脓毒症患者血清降钙素原（PCT）、C-反应蛋白（CRP）与凝血功能、病情评分的关系及预后的影响因素。方法：选择2017年8月至2019年10月我院诊治的150例脓毒症患者作为研究对象，根据脓毒症组患者的生存状况将其分为存活组（n=118）和死亡组（n=32）。检测两组患者血清PCT、CRP水平，凝血酶原时间（PT）和部分凝血活酶时间（APTT）。采用急性生理功能和慢性健康状况评分系统Ⅱ(APACHEⅡ)和序贯器官衰竭估计(SOFA)对两组患者病情进行评估。比较两组患者临床资料。相关性分析采用Pearson检验。患者预后的影响因素采用多因素Logistic回归分析。结果：与存活组相比，死亡组血清PCT、CRP，PT、APTT，APACHE II和SOFA评分均明显升高（P<0.05）。血清PCT>7.32 ng/mL、CRP>86.73 ng/mL、PT>15.48s、APTT>36.74s、APACHE Ⅱ评分>15.88分和SOFA评分>6.48分均是脓毒症患者死亡的危险因素（OR=2.099、1.747、2.333、1.596、1.916、2.208，P<0.05）。血清PCT和CRP均与APACHE Ⅱ评分、SOFA评分、PT和APTT呈正相关（P<0.05）。结论：血清PCT和CRP水平升高与脓毒症患者死亡相关，两者与脓毒症患者APACHE Ⅱ评分、SOFA评分、PT和APTT存在正相关，并且是患者不良预后的影响因素，在脓毒症患者预后的评估中具有一定临床价值。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the relationship between serum procalcitonin (PCT), C-reactive protein (CRP), coagulation function, disease score and prognostic factors in patients with sepsis. Methods: A total of 150 patients with sepsis who were diagnosed and treated in our hospital from August 2017 to October 2019 were selected as the study subjects. According to the survival status of the patients in the sepsis group, they were divided into survival group (n=118) and death group (n=32). Serum levels of PCT, CRP and prothrombin time (PT), partial thromboplastin time (APTT) in each group were detected by latex enhanced immunoturbidimetry. Acute physiological function and chronic health status scoring systemⅡ (APACHEⅡ) and sequential organ failure assessment (SOFA) were used to evaluate the condition of the two groups. The clinical data of the two groups were compared. Pearson test was used for correlation analysis. The influencing factors of patients' prognosis were analyzed by logistic regression. Results: Compared with survival group, serum calcitonin original, PCT, CRP, PT, APTT, APACHE II and SOFA score in death group increased significantly (P<0.05). Serum PCT>7.32 ng/mL, CRP>86.73 ng/mL, PT>15.48s, APTT>36.74s, APACHE Ⅱ score >15.88 score and SOFA score >6.48 were the major risk factors of death in patients with sepsis（OR=2.099, 1.747, 2.333, 1.596, 1.916, 2.208, P<0.05）. Serum PCT and CRP and APACHE Ⅱ score, SOFA score, PT and APTT were positively correlated (P<0.05). Conclusion: The increase of serum PCT and CRP levels are related to the death of patients with sepsis, and they are positively related to Apache Ⅱ score, SOFA score, PT and APTT of patients with sepsis, and they are the influencing factors of poor prognosis of patients. They have a certain clinical value in the evaluation of prognosis of patients with sepsis. |
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