降钙素原结合APACHE Ⅱ评分在老年重症感染患者中的诊断和预后意义.pdf

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1、中国感染与化疗杂志2015年1月20日第15卷第1期ChinJInfectChemother，Jan．2015，Voi15，No147·论著·降钙素原结合APACHEII评分在老年重症感染患者中的诊断和预后意义郑秀芹，钟晓梅，马建华，王一冰摘要：目的评价血清降钙素原(PCT)结合急性生理与慢性健康(APACHE1I)评分在重症监护病房(Icu)老年重症感染患者中病情预测的价值。方法回顾性分析承德市中心医院ICU249例患者l临床资料，根据临床表现、实验室检查，分为感染组131例，其中脓毒症48例，重度脓毒症43例，脓毒性休克40例；非感染组118例。比较两组PCT水平和APACHE1I

2、评分结果。结果感染组PCT水平显著高于非感染组，差异有统计学意义(P<0．O1)；感染组中，PCT水平及APACHE1评分均随病情加重而增高，差异有统计学意义(P<0．05)。PCT与APAcHEⅡ评分显著相关(P<0．05)。结论PCT结合APACHEⅡ评分在指导1CU老年重症感染患者病情预测方面有重要临床参考价值。关键词：降钙素原；急性生理与慢性健康评分；重症感染；病情预测中图分类号：R631文献标志码：A文章编号：1009—7708(2015)01—0047—04Diagnosticandprognosticimplicationofprocalcitonincombinedwi

3、thAPACHEⅡscoreinelderlypatientswithsevereinfectionZHENGXiuqin。ZHONGXiaomei，MAJianhua，WANGgibing．(CardiothoracicSurgery，ChengdeCentralHospital，ChengdeHebei067000，China)Abstract：ObjectiveToevaluatetheearlydiagnosticandprognosticimplicationofprocalcitonin(PCT)combinedwithAPACHE1Iscoreinelderlypatie

4、ntswithsevereinfectioninintensivecareunit(ICU)．MethodsTheclinicaldataof249patientsinICUofChengdeCentralHospitalwereretrospectivelyanalyzed．Accordingtotheclinicalmanifestations，laboratoryexamination．microbiologytests，249patientsweredividedintoinfectiongroup(131cases)andnon-infectiongroup(118cases

5、)．Thepatientsintheinfectiongroupwerestratifiedinto3stratabasedonseverityofinfection，specifically：sepsis(48cases)，severesepsis(43cases)，andsepticshock(40cases)．PCTandAPACHE1Iscorewerecomparedbetweengroupsandstrata．ResultsThePCTlevelofinfectiongroupwassignificantlyhigherthanthatofnon-infectiongrou

6、p(P％0．01)．Intheinfectiongroup．higherPCTlevelandAPACHEIIscoreweresignificantlyassociatedwithworseconditionsofpatients(P<0．05)．PCTlevelwasalsosignificantlycorrelatedwithAPACHE1Iscore(P<0．05)．ConclusionsPCTlevelisimportantinearlydiagnosisofsevereinfectionofelderlypatientsinICU．PCTcombinedwithAPACHE

7、1IscoremayprovideimportantvalueinassessingtheseverityofinfectionfortheelderlypatientsinICU．Keywords：procalcitonin；APACHE1I；severeinfection；diseaseprediction重症感染是重症监护病房(ICU)危重症患者死程度、及时采取有效措施，对改善老年重症患者预亡的主要原因之一。老年患者往往症状不典型，病后、