[1]刘振国a,王 婷b,王顺达c,等.重症肺炎并发脓毒症患者血清降钙素原、血乳酸及内毒素水平的相关研究[J].现代检验医学杂志,2017,32(02):95-97，164.[doi:10.3969/j.issn.1671-7414.2017.02.026]
　LIU Zhen-guoa,WANG Tingb,WANG Shun-dac,et al.Crelational Research of the Level of Plasma Procalcitonin,BloodLactic Acid and Endotoxin in Patients of Severe Pneumonia Complicated with Sepsis[J].Journal of Modern Laboratory Medicine,2017,32(02):95-97，164.[doi:10.3969/j.issn.1671-7414.2017.02.026]
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重症肺炎并发脓毒症患者血清降钙素原、血乳酸及内毒素水平的相关研究()
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《现代检验医学杂志》[ISSN:/CN:]

卷:
第32卷
期数:
2017年02期
页码:
95-97，164
栏目:
论著
出版日期:
2017-03-25

文章信息/Info

Title:
Crelational Research of the Level of Plasma Procalcitonin,BloodLactic Acid and Endotoxin in Patients of Severe Pneumonia Complicated with Sepsis
文章编号:
1671-7414(2017)02-095-04
作者:
刘振国a; 王 婷b; 王顺达c; 卢晓娥a; 尹贻明a
陕西省人民医院 西安交通大学第三附属医院a.重症医学科; b.西院干部一病区; c.急诊内科,西安 710068
Author(s):
LIU Zhen-guoa; WANG Tingb; WANG Shun-dac; LU Xiao-ea; Yin Yi-minga
a.Intensive Care Unit; b.Cadres Ward; c.Emergency Department,Shaanxi Provincial People's Hospital, the Third Affiliated Hospital of Medical School,Xi'an Jiaotong University,Xi'an 710068,China
关键词:
重症肺炎;  脓毒症;  血清降钙素原;  血乳酸;  内毒素
分类号:
R563.1; R446.112
DOI:
10.3969/j.issn.1671-7414.2017.02.026
文献标志码:
A
摘要:
目的 探讨重症肺炎并发脓毒症患者中血清降钙素原(PCT)、血乳酸(Lac)及内毒素水平的变化研究。方法 收集陕西省人民医院重症医学科40例重症肺炎并发脓毒症患者(观察组),分为存活组20例和死亡组20例,入院后进行急性生理与慢性健康评分(APACHEⅡ评分),选入院后最初24 h内评分最差值。同时选取20例健康体检人群作为正常对照组,比较各组血清PCT,血Lac及内毒素的水平,对血清PCT,血Lac,内毒素及APACHEⅡ评分进行相关性研究。结果 与正常对照组(0.02±0.01 ng/ml,0.87±0.27 mmol/L,4.15±1.63 pg/ml)比较,观察组血清PCT,血Lac及内毒素水平均升高(18.29±11.02 ng/ml,6.55±3.02 mmol/L和15.5±10.38 pg/ml),差异均有统计学意义(t=10.48,11.79,6.75,均P<0.05); 与存活组(9.52±2.93 ng/ml,4.26±1.78 mmol/L,7.62±3.04 pg/ml)比较,死亡组血清PCT,血Lac及内毒素水平均升高(27.06±8.88 ng/ml,8.84±2.14 mmol/L和23.39±9.00 pg/ml),差异均有统计学意义(t=8.39,7.35,7.42,均P<0.05); 血清PCT,血Lac,内毒素与APACHEⅡ评分之间呈正相关(r=0.919,P=0.001; r=0.914,P=0.002; r=0.909,P=0.004)。结论 血清PCT,血Lac及内毒素是评估重症肺炎并发脓毒症患者病情严重程度和预后的重要指标。
Abstract:
Objective To evaluate the clinical value of thelevel of plasma procalcitonin,blood lactic acid and endotoxin in patients of severe pneumonia complicated with sepsis.Methods The 40cases of severe pneumonia complicated with sepsis(observation group)were analyzed retrospectively,they were divided into survival group included 20 cases and the death group included 20 cases.Meanwhile the 20 cases of healthy persons wereselected as control group.The worst score of Acute Physiology and Chronic Health Evaluation Ⅱ(APACHE Ⅱ)within 24 hours after admission were record.The level of plasma procalcitonin,blood lactic acid and endotoxin were compared between three groups.In addition do a correlation study between the above indexes and the score of APACHE Ⅱ.Results The level of plasma Procalcitonin,blood lactic acid and endotoxin of observation group increased significantly compared with the control group [(0.02±0.01 ng/ml,0.87±0.27 mmol/L,4.15±1.63 pg/ml)vs(18.29±11.02 ng/ml,6.55±3.02 mmol/L and 15.5±10.38 pg/ml),t=10.48,11.79,6.75,all P<0.05].The level of plasma procalcitonin,blood lactic acid and endotoxin of the death group increased significantly compared with the survival group [(9.52±2.93 ng/ml,4.26±1.78 mmol/L,7.62±3.04 pg/ml)vs(27.06±8.88 ng/ml,8.84±2.14 mmol/Land 23.39±9.00 pg/ml),t=8.39,7.35,7.42,all P<0.05].In theall patients of severe pneumonia complicated with sepsis,there was positive correlation among plasma procalcitonin,blood lactic acid,endotoxin and the score of APACHE Ⅱ(r=0.919,P=0.001; r=0.914,P=0.002; r=0.909,P=0.004).Conclusion The level of plasma procalcitonin,blood lactic acid and endotoxin are very important indexes in assessment of the severityand the prognosis of severe pneumonia complicated with sepsis,that has important value in clinical application.

参考文献/References:

[1] 叶 华,李 莉,钟贵芳,等.SICU严重脓毒症患者血降钙素原和乳酸清除率的临床分析[J].岭南现代临床外科,2015,15(6):707-710. Ye H,Li L,Zhong GF,et al.Clinical analysis of serum procalcitonin and lactate clearance in patients with severe sepsis in SICU[J].Lingnan Modern Clinics in Surgery,2015,15(6):707-710.
[2] Dellinger RP,Levy MM,Rhodes A,et al.Surviving sepsis campaign:international guidelines for management of severe sepsis and septic shock,2012[J].Crit Care Med,2013,41(2):580-637.
[3] Mandell LA,Wunderink RG,Anzueto A,et al.Infectious diseases society of America/American thoracic society consensus guidelines on the management of community-acquired pneumonia in adults[J].Clinical Infectious Diseases,2007,44(Suppl 2):S27-S72.
[4] 尹小燕,乔建瓯.甲状腺激素、降钙素原和C-反应蛋白对脓毒症患者病情及预后评估的价值[J].中华实验和临床感染病杂志(电子版),2016,10(2),162-165. Yin XY,Qiao JO.Evaluating value of thyroid hormone and procalcitonin and C-reactive protein in patients with sepsis[J].Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition),2016,10(2),162-165.
[5] 石 岩,刘大为.降钙素原在全身性感染诊治中的研究进展[J].中华内科杂志,2011,50(5):444-446. Shi Y,Liu DW.Research progress of procalcitonin in the diagnosis and treatment of systemic infection[J].Chinese Journal of Internal Medicine,2011,50(5):444-446.
[6] 刘婷婷,袁 喆.降钙素原的临床应用及研究进展[J].西部医学,2014,26(10):1408-1411. Liu TT,Yuan Z.The clinical application and research progress of procalcitonin[J].Medical Journal of West China,2014,26(10):1408-1411.
[7] 秦海萍,庄建晴,曹维锷,等.降钙素原联合内毒素检测对老年脓毒症的临床意义[J].贵阳医学院学报,2016,41(4),483-486,490. Qin HP,Zhuang JQ,Cao WE,et al.Clinical significance of procalcitonin and endotoxin detection in elderly sepsis[J].Journal of Guizhou MedicalCollege,2016,41(4),483-486,490.
[8] 黄志俭,雷利华,孙斐予,等.血浆内毒素在革兰阴性菌脓毒血症诊断及预后价值的研究[J].中华临床医师杂志(电子版),2016,10(4),217-218. Huang ZJ,Lei LH,Sun FY,et al.The study on the value of plasma endotoxin in leather gram-negative bacteria sepsis diagnosis and prognosis[J].Chinese Journal of Clinicians(Electronic Edition),2016,10(4),217-218.
[9] 王 征,汤 辉,曹 涛,等.降钙素原和乳酸对急诊老年严重脓毒症和脓毒性休克患者预后的评估价值[J].现代中西医结合杂志,2016,25(19),2057-2059. Wang Z,Tang H,Cao T,et al.Assess value of procalcitonin and lactate acid for the prognosis of emergency elderly patients with severe sepsis andsepsis shock[J].Modern Journal of Integrated Traditional Chinese and WesternMedicine,2016,25(19),2057-2059.
[10] Knaus WA,Draper EA,Wagner DP,et al.APACHEⅡ:a severity of disease classfication system[J].Crit Care Med,1985,13(10):818-829.
[11] Bao B,Li ZG,Sun XL.Blood lactic acid level and APACHE Ⅱ score on prognosis of critically ill elderly patients[J].Chinese Journal of Epidemiology,2012,33(4):428-430.

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备注/Memo

备注/Memo:

作者简介:刘振国(1982-),女,医学硕士,主治医师,从事急危重症病研究工作,Tel:13484622631,E-mail:379740078@qq.com。
更新日期/Last Update: 2017-04-10