降钙素原、超敏C反应蛋白及D—二聚体在脓毒症所致急性呼吸窘迫综合征中的诊断和预后评估价值(1)
[摘要] 目的 探究降钙素原(PCT)、超敏C反应蛋白(hs-CRP)及D-二聚体在脓毒血症所导致的急性呼吸窘迫综合征(ARDS)中的诊断及预后评估价值。 方法 选取2015年1月～2017年1月于海南医学院第一附属医院治疗的脓毒症导致的ARDS患者82例，按照患者严重程度将其分为重症组(33例)与非重症组(49例)，按照患者结局将其分为非死亡组(69例)与死亡组(13例)，另选取同期100例健康体检者为健康对照组，分别对几组患者的血清PCT、hs-CRP及D-二聚体水平进行评测和比较。 结果 血清PCT、hs-CRP及D-二聚体水平，重症组>非重症组>健康对照组，差异有统计学意义(P < 0.05)；血清PCT、hs-CRP及D-二聚体水平，死亡组>非死亡组>健康对照组，差异有统计学意义(P < 0.05)；相关性分析显示，血清PCT、hs-CRP及D-二聚体水平与患者预后呈正相关(r = 0.634、0.518、0.537，P < 0.05)。 结论 血清PCT、hs-CRP及D-二聚体水平与脓毒症所致ARDS病情和预后具有一定相关性，血清因子水平越高，患者病情越重、预后越差。
[关键词] 降钙素原；超敏C反应蛋白；D-二聚体；诊断；预后
[中图分类号] R459.7 [文献标识码] A [文章编号] 1673-7210(2018)08(a)-0074-04
[Abstract] Objective To investigate the value of diagnosis and prognostic evaluation on acute respiratory distress syndrome (ARDS) caused by sepsis and procalcitonin (PCT)， high-sensitivity C-reactive protein (hs-CRP)， D-dimer. Methods From January 2015 to January 2017， in the First Hospital Affiliated to Hainan Medical College， 82 sepsis-causing ARDS patients were selected. According to the severity of patients， they were divided into severe group (33 cases) and non-severe group (49 cases)， according to the ending of patients， they were divided into non-death group (69 cases) and death group (13 cases). At the same period， 100 healthy physical examinations were selected as healthy control group. Serum PCT， hs-CRP， and D-dimer levels in the group were evaluated and compared. Results Serum PCT， hs-CRP， and D-dimer levels in Severe group > non-severe group > healthy control group， the differences were statistically significant (P < 0.05)； serum PCT， hs-CRP and D-dimer levels in death group > non-death group > healthy control group， the differences were statistically significant (P < 0.05). Correlation analysis revealed that serum PCT， hs-CRP and D-dimer levels were positively correlated with patient outcome (r = 0.634， 0.518， 0.537， P < 0.05). Conclusion Serum PCT， hs-CRP， and D-dimer levels are associated with sepsis-induced ARDS disease and prognosis. The more severe the patient′s condition and the worse the prognosis， the higher the above-mentioned serum factor levels.
[Key words] Procalcitonin； High-sensitivity C-reactive protein； D-dimer； Diagnosis； Prognosis
膿毒症是指因为感染引发的全身炎性反应，该症发生率较高，统计数据显示，全世界每年约有1800万新发脓毒症患者，且近些年该数字仍以每年8.0%的速度持续攀升，脓毒症具有发病急、病情危等特点，全球每天死于该症的人数高达1.5万，该数字已超过心肌梗死致死人数，虽然新型抗菌药物不断出现，但脓毒症的致死率仍高达30%～70%[1-2]。脓毒症往往会造成机体多器官衰竭，其中肺部常为最早出现病变的器官，临床上表现为急性呼吸窘迫综合征(ARDS)，ARDS会使患者出现低氧血症、呼吸困难等症状，病情危急，早期对病情的诊断是提高患者预后的重要手段[3-4]。降钙素原(PCT)为机体内反映炎性反应严重程度的一类蛋白，但局部感染不会引起PCT水平的上升，超敏C反应蛋白(hs-CRP)是全身炎性反应急性期的非特异性标志物，也是预测心血管事件的重要指标之一，D-二聚体为机体内畸形血栓形成的非特异性标志物，笔者通过研究发现，血清PCT、hs-CRP及D-二聚体水平与脓毒症所致ARDS病情和预后具有一定相关性，患者病情越重、预后越差，上述血清因子水平越高，现将结果报道如下：, http://www.100md.com(冼丽娜 杨远征 陈伟 孙广晓)
[关键词] 降钙素原；超敏C反应蛋白；D-二聚体；诊断；预后
[中图分类号] R459.7 [文献标识码] A [文章编号] 1673-7210(2018)08(a)-0074-04
[Abstract] Objective To investigate the value of diagnosis and prognostic evaluation on acute respiratory distress syndrome (ARDS) caused by sepsis and procalcitonin (PCT)， high-sensitivity C-reactive protein (hs-CRP)， D-dimer. Methods From January 2015 to January 2017， in the First Hospital Affiliated to Hainan Medical College， 82 sepsis-causing ARDS patients were selected. According to the severity of patients， they were divided into severe group (33 cases) and non-severe group (49 cases)， according to the ending of patients， they were divided into non-death group (69 cases) and death group (13 cases). At the same period， 100 healthy physical examinations were selected as healthy control group. Serum PCT， hs-CRP， and D-dimer levels in the group were evaluated and compared. Results Serum PCT， hs-CRP， and D-dimer levels in Severe group > non-severe group > healthy control group， the differences were statistically significant (P < 0.05)； serum PCT， hs-CRP and D-dimer levels in death group > non-death group > healthy control group， the differences were statistically significant (P < 0.05). Correlation analysis revealed that serum PCT， hs-CRP and D-dimer levels were positively correlated with patient outcome (r = 0.634， 0.518， 0.537， P < 0.05). Conclusion Serum PCT， hs-CRP， and D-dimer levels are associated with sepsis-induced ARDS disease and prognosis. The more severe the patient′s condition and the worse the prognosis， the higher the above-mentioned serum factor levels.
[Key words] Procalcitonin； High-sensitivity C-reactive protein； D-dimer； Diagnosis； Prognosis
膿毒症是指因为感染引发的全身炎性反应，该症发生率较高，统计数据显示，全世界每年约有1800万新发脓毒症患者，且近些年该数字仍以每年8.0%的速度持续攀升，脓毒症具有发病急、病情危等特点，全球每天死于该症的人数高达1.5万，该数字已超过心肌梗死致死人数，虽然新型抗菌药物不断出现，但脓毒症的致死率仍高达30%～70%[1-2]。脓毒症往往会造成机体多器官衰竭，其中肺部常为最早出现病变的器官，临床上表现为急性呼吸窘迫综合征(ARDS)，ARDS会使患者出现低氧血症、呼吸困难等症状，病情危急，早期对病情的诊断是提高患者预后的重要手段[3-4]。降钙素原(PCT)为机体内反映炎性反应严重程度的一类蛋白，但局部感染不会引起PCT水平的上升，超敏C反应蛋白(hs-CRP)是全身炎性反应急性期的非特异性标志物，也是预测心血管事件的重要指标之一，D-二聚体为机体内畸形血栓形成的非特异性标志物，笔者通过研究发现，血清PCT、hs-CRP及D-二聚体水平与脓毒症所致ARDS病情和预后具有一定相关性，患者病情越重、预后越差，上述血清因子水平越高，现将结果报道如下：, http://www.100md.com(冼丽娜 杨远征 陈伟 孙广晓)