资源描述：
《降钙素原和常用炎症指标在严重脓毒症中表达及临床意义.doc》由会员上传分享，免费在线阅读，更多相关内容在工程资料-天天文库。
1、降钙素原和常用炎症指标在严重脓毒症中表达及临床意义ClinicalsignificanceofprocalcitoninandcommoninflammatorymarkersinpatientswithseveresepsisLAbstract】ObjectiveTostudythediagnosticvalueofprocalcitonin(PCT)andcommoninflammatorymarkersinpatientswithseveresepsis・MethodsPatientswereobservedcontinuouslyi
2、naperspectivestudywithdiagnosticLests.AccordingtothedefinitionofACCP/SCCMConsensusConference,patientswereclassifiedinto2groups,includingsepsisgroupandseveresepsisgroup・IndexesofinflammationandconcentrationofPCT,Creactiveprotein(CRP)andwhitebloodcells(WBC)weredeterminedat24
3、hours,andtheircorrelationwasanalyzed・ResuItsonehundredandninepatientswereenrolled,including52insepsisgroup,59inseveresepsisgroup・PCT,CRPandwbclevelsweresignificantlyhigherinseveresepsisgroup,PCTconcentrationswerepositivelycorrelatedwiththeCRPandwbclevels・Spearmanfscorrelat
4、ioncoefficientwas0.260(P二0.006)and0.443(P=0.000)・Inthediagnosisofseveresepsis,PCTyieldedthesignificantlyhighestdiscriminativevalue,withanAUCof0.872(CI,0.795to0.928),followedbyWBC(0.747;CI,0.654to0.825;P=0.026),andCRP(0.736;CI,0.643to0.816;P=0.009).Atacutoffof0.9ng/ml,PCTyi
5、eldedasensitivityof73.7%andaspecificityof84.6%todifferentiatepatientswithseveresepsisfromnon—severesepsis.MedianPCTconcentrationsonadmission(ng/ml,range)were0.34(0.16to0.73)forsepsis:2.79(0.58to5.38)forseveresepsis(P<0.001).ConclusionPCTcombiningwiththetraditionalinflammat
6、orymarkersishelpfulforthediagnosisofseveresepsis,PCTyieldedthesignifiedntlyhighestdiscriminativevalue.[Keywords]severesepsis:procalcitonin;Creactiveprotein;whitebloodcells摘要：目的对降钙素原和临床常用指标(C反应蛋白，白细胞计数)进行联合检测，评价它们在严重脓毒症中的诊断价值。方法：釆用前瞻性、临床病例观察及诊断试验研究。根据美国胸科医师协会/危重病医学会(ACCP/SC
7、CM)共识会议，严格将入选病例分为非严重脓毒症组、严重脓毒症组。测定24小时内的炎症指标、降钙素原浓度并进行统计分析。结果409例患者入选，其中脓毒症组52例，严重脓毒症组59例。三项炎症指标在严重脓毒症组的表达都有显著升高，与脓毒症组比较差异均有统计学意义。相关分析表明，PCT的表达与CRP和WBC的表达呈正相关，Spearman相关系数分别为0.260(P=0.006),0.443(P=0.000)o受试者工作特征曲线(ROC曲线)分析发现，PCT的曲线下面积0.872(0.795,0.928),WBC为0.747(0.654,0.82
8、5；P=0.026),CRP为0.736(0.643,0.816；P=0.009)oPCT与CRP及WBC的曲线下面积比较，差别均有统计学意义。PCT诊断严重脓毒症时的最佳临界值
