降钙素原测定对腹腔感染性休克的预后判断价值(1)
【摘要】 目的：观察、分析、比较降钙素原对于腹腔感染性休克和肺部感染性休克的预后判断价值差别。方法：分别于入科24 h内抽取PCT、内毒素以及动脉血测定乳酸，并根据24 h内最差临床指标计算APACHE Ⅱ评分，比较相同分组下不同预后及不同分組下相同预后患者之间PCT、内毒素、血清乳酸、APACHE Ⅱ评分之间的差异。结果：不同预后患者入院第1天死亡组PCT水平、血清乳酸、APACHE Ⅱ评分、内毒素显著高于存活组(P<0.05)。相同预后死亡组中，第一组的PCT、血清乳酸、APACHE Ⅱ评分明显高于第二组(P<0.05)，内毒素高于第二组但比较差异无统计学意义(P>0.05)。结论：相对于肺部感染性休克而言，降钙素原测定较内毒素能够更为准确的判断腹腔感染性休克患者的预后，与血清乳酸、APACHE Ⅱ评分具有较高的一致性。对于腹腔感染性休克患者，早期测定降钙素原能够反映腹腔感染的严重程度，也更有利于临床医师对治疗效果和预后的判断，从而更加合理地选择抗生素，值得临床上进一步推广、应用。
【关键词】 降钙素原； 腹腔； 感染性休克； 预后
【Abstract】 Objective：To observe，analyze and compare the clinical significance of calcitonin in the treatment of abdominal cavity septic shock and pulmonary septic shock.Method：Respectively into the branch within 24 hours of PCT，endotoxin， and arterial blood lactic acid determination，according to the 24 hours of the worst clinical indicators of APACHE Ⅱ score，the differences of the same group between the different prognosis and the different groups under the same the prognosis of patients were compared with PCT， serum endotoxin， lactic acid，and APACHE Ⅱ score.Result：The different prognosis of patients on the first day after admission with PCT levels， APACHE Ⅱ score， serum lactic acid and endotoxin in the death group were significantly higher than the survival group(P<0.05).In the same prognosis of death group， PCT， serum lactate and APACHE Ⅱ score of the first group were significantly higher than those of the second groups(P<0.05)， but the difference in endotoxin was not statistically significant(P>0.05).Conclusion：Compared with the patients with pulmonary septic shock，procalcitonin is more accurate than endotoxin in predicting the prognosis of patients with abdominal cavity septic shock， which is consistent with that of serum lactate and APACHE Ⅱ.The abdominal cavity in patients with septic shock，early determination of procalcitonin can reflect the severity of abdominal infection， but also more conducive to the clinician to judge the effect of treatment and the prognosis of the choice of antibiotics， which is more reasonable，it is worthy of further promotion and clinical application.
【Key words】 Procalcitonin； Abdominal cavity； Septic shock； Prognosis
First-author’s address：The First Affiliated Hospital of Gannan Medical University，Ganzhou 341000，China
doi：10.3969/j.issn.1674-4985.2017.07.029
深腹腔感染性休克是常见的感染性疾病，治疗有一定难度，而且常由于治疗不彻底，造成反复发作[1]。目前，白细胞、体温及C反应蛋白作为临床常用的感染识别辅助检查，都存在敏感性及特异性不高的缺陷[2]。本研究以本院收治的100例腹腔感染性休克患者以及100例呼吸系统感染性休克作为研究对象，探讨降钙素原对于腹腔感染性休克和肺部感染性休克的临床意义，内容报告如下。, http://www.100md.com(林洁 曾繁林 刘欣)
【关键词】 降钙素原； 腹腔； 感染性休克； 预后
【Abstract】 Objective：To observe，analyze and compare the clinical significance of calcitonin in the treatment of abdominal cavity septic shock and pulmonary septic shock.Method：Respectively into the branch within 24 hours of PCT，endotoxin， and arterial blood lactic acid determination，according to the 24 hours of the worst clinical indicators of APACHE Ⅱ score，the differences of the same group between the different prognosis and the different groups under the same the prognosis of patients were compared with PCT， serum endotoxin， lactic acid，and APACHE Ⅱ score.Result：The different prognosis of patients on the first day after admission with PCT levels， APACHE Ⅱ score， serum lactic acid and endotoxin in the death group were significantly higher than the survival group(P<0.05).In the same prognosis of death group， PCT， serum lactate and APACHE Ⅱ score of the first group were significantly higher than those of the second groups(P<0.05)， but the difference in endotoxin was not statistically significant(P>0.05).Conclusion：Compared with the patients with pulmonary septic shock，procalcitonin is more accurate than endotoxin in predicting the prognosis of patients with abdominal cavity septic shock， which is consistent with that of serum lactate and APACHE Ⅱ.The abdominal cavity in patients with septic shock，early determination of procalcitonin can reflect the severity of abdominal infection， but also more conducive to the clinician to judge the effect of treatment and the prognosis of the choice of antibiotics， which is more reasonable，it is worthy of further promotion and clinical application.
【Key words】 Procalcitonin； Abdominal cavity； Septic shock； Prognosis
First-author’s address：The First Affiliated Hospital of Gannan Medical University，Ganzhou 341000，China
doi：10.3969/j.issn.1674-4985.2017.07.029
深腹腔感染性休克是常见的感染性疾病，治疗有一定难度，而且常由于治疗不彻底，造成反复发作[1]。目前，白细胞、体温及C反应蛋白作为临床常用的感染识别辅助检查，都存在敏感性及特异性不高的缺陷[2]。本研究以本院收治的100例腹腔感染性休克患者以及100例呼吸系统感染性休克作为研究对象，探讨降钙素原对于腹腔感染性休克和肺部感染性休克的临床意义，内容报告如下。, http://www.100md.com(林洁 曾繁林 刘欣)