降钙素原和N末端前体脑钠肽对脓毒血症预后评估意义的研究-论文.pdf

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1、·48·中华临床医师杂志r电子版)2014年5月第8卷第lO期chilIJClinicians(E1~ctronicEdition)．Mas'15。2014，v01．8'N0．Q·临床论著●降钙素原和N末端前体脑钠肽对脓毒血症预后评估意义的研究郭少卿邹原方【摘要】目的探讨血清降钙素原(PCT)和N末端前体脑钠肽(NT-proBNP)对脓毒血症预后评估的临床意义。方法72例脓毒血症患者按预后分为存活组和死亡组，比较发病早期PCT、NT-proBNP及急性生理与慢性健康状况(APACHEII)评分，并建立ROC曲线观察两种标记物对预后评估的临床价值。结果PCT、NT-proBNP和A

2、PACHEII评分两组患者中均有统计学差异(P

3、procalcitoninandn-terminalprobrainnatriureticpeptideinpatientswithsepsisGuoShaoqing',ZouYuanfang．"DepartmentofEmergency,TheAfiliatedDonghuaHospitalofSunYet-SenUniversity,Dongguan523220,ChinaCorrespondingauthor：ZouYuanfang,Email：zouyuanfang2008@163．corn[Abstract]0bjectiveToevaluatetheprognosti

4、cvalueofprocalcitonin(PCT)andN-temfinalprobrainnatriureticpeptide(NT-proBNP)．MethodsSeventy·twopatientswi廿lsepsisweredividedintosurvivalgroupanddeathgroupaccordingtotheiroutcome．LevelsofPCTandNT．proBNPweremeasuredintheearlystageoftreatment，andAPACHEI1werescored．ROCwasconstructedtoobservethepr

5、ognosticvalueofthebiomarkers．ResultsThereweresignificantdiferencesinlevelsofbothbiomarkersandAPACHEIIscorebetweengroups，andbothwereobviouslycorrelatedwithAPACHEIIscore．Theareaunderthecurve(AUC)ofPCTandNT-proBNPwere0．822andO．843，respectively．ThesensibilityandspecificityofPCTwere78-3％and71．4％．w

6、hilethesensibilityandspecificityofNT-proBNPwere82．6％and85．7％．NT-proBNPwasbeRerthanPCTinevaluatingprognosisofsepsis．ThespecificitywashigherwhenPCTandNT-proBNPwerecombinedtoevaluateprognosis(90．O％、．ConclusionPCTandNT-proBNParebothgoodbiomarkersforevaluatingpatients’prognosis，andcombinedevaluati

7、onCanincreasethespecificity．[Keywords]Sepsis；Procalcitonin；N—terminalprobrainnatriureticpeptide重症监护病房(ICU)和急诊重症监护病房肽(N—terminalprobrainnalriureticpeptide，(EICU)中脓毒血症的发生率为l1％---15％，死亡NT-proBNP)均可在严重脓毒血症时出现异常升高，率高达30％以上早期对脓毒血症进行预测，以对脓毒血症的诊断有明确意