[1]戴晓勇,陈永珍,华玮,等.血清淀粉样蛋白A,C反应蛋白和降钙素原在脓毒性休克中的应用价值与相关性分析[J].现代检验医学杂志,2019,34(01):47-50.[doi:10.3969/j.issn.1671-7414.2019.01.012]
　DAI Xiao-yong,CHEN Yong-zhen,HUA Wei,et al.Application and Correlation Analysis of Serum Amylase A， C-reactive Protein and Procalcitonin in Septic Shock[J].Journal of Modern Laboratory Medicine,2019,34(01):47-50.[doi:10.3969/j.issn.1671-7414.2019.01.012]
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血清淀粉样蛋白A,C反应蛋白和降钙素原在脓毒性休克中的应用价值与相关性分析()
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《现代检验医学杂志》[ISSN:/CN:]

卷:
第34卷
期数:
2019年01期
页码:
47-50
栏目:
论著
出版日期:
2019-02-28

文章信息/Info

Title:
Application and Correlation Analysis of Serum Amylase A， C-reactive Protein and Procalcitonin in Septic Shock
文章编号:
167 1-7414(2019)01-047-04
作者:
戴晓勇; 陈永珍; 华玮; 沈健; 叶宥文; 杨晓英; 石斌
同济大学附属杨浦医院(杨浦区中心医院)急诊科，上海200090
Author(s):
DAI Xiao-yong; CHEN Yong-zhen; HUA Wei; SHEN Jian; YE You-wen; YANG Xiao-ying; SHI Bin
(Department of Emergency，Affiliated Yangpu Hospital of Tongji University，Yangpu District Central Hospital，Shanghai 200090，C hina)
关键词:
脓毒性休克; 血清淀粉样蛋白A; 降钙素原; C反应蛋白; 预后
分类号:
R631；R446.112
DOI:
10.3969/j.issn.1671-7414.2019.01.012
文献标志码:
A
摘要:
目的：分析血清淀粉样蛋白A(SAA)，C反应蛋白(CRP)和降钙 素原(PCT)在脓毒性休克中的诊断及预后的评估价值。方法将同济 大学附属杨浦医院急诊科收治的89例脓毒症患者根据病情分为脓毒性休克组( n =41)、非 脓毒性休克组( n =48)；同时根据预后情况分为预后良好组( n =58)和预后不良组( n =31)。比较各组SAA，PCT，CRP水平及序贯器衰竭评估(SOFA)评分的变化，并分析各炎 症指标联合检测对脓毒性休克患者预后的预测价值。结果与非脓毒 性休克组比较，脓毒性休克组SAA(280.27±14.16 mg/L vs 251.87±25.20 mg/L)，CR P(105.74±23.57 mg/L vs 84.25±15.27 mg/L)，PCT(7.11±2.54 μg/L vs 3.34 ±1.84 μg/L)，SOFA评分(9.03±2.37 vs 5.75±2.05)均明显升高，差异有统计学意 义( t=6.61，5.07，7.97，6.96，均P <0.001)。预后不良组SAA(291.32±15.28 mg/L vs 242.35±24.88 mg/L)，PCT(7.28±2.69 μg/L vs 2.44±1.24 μg/L)，SO FA评分(9.16±2.25 vs 5.34±1.80)较预后良好组显著升高，差异有统计学意义( t=1 1.27，10.77，8.81，均P <0.001)。非脓毒性休克患者SOFA评分与SAA( r=0.372，P =0.041)，PCT( r=0.354，P =0.047)呈显著正相关，而与CRP无显著相关性( r=0. 289，P =0.071)；脓毒性休克患者SOFA评分与SAA( r=0.414，P =0.024)，CRP( r=0 .342，P =0.044)，PCT( r=0.395，P =0.031)均呈显著正相关( P <0.05)。联合 检测预测脓毒性休克患者预后的AUC(0.96 vs 0.84，0.67，0.82)、灵敏度(0.81±0. 21 vs 0.78±0.20，0.60±0.22，0.75±0.25)、特异度(0.74±0.25 vs 0.72±0 .24，0.63±0.17，0.71±0.28)均显著高于SAA，PCT，PCR单独检测( P <0.05)。 结论SAA，PCT和CRP是脓毒性休克患者病情严重程度及预后的有效 评价指标，在SOFA的基础上，联合SAA，PCT，CRP可进一步提高脓毒性休克预后预测的敏感 性。
Abstract:
Objective To explore the evaluation value of s erum amylase A(SAA)，C-reactive protein (CRP) and procalcitonin (PCT) in the di agnosis and prognosis of septic shock．Methods According to the severity of disease，89 patients with sepsis who were admitted in the dep artment of emergency were divided into two groups，including 41 patients of sept ic shock group，48 patients of non-septic shock group．All the patients were al so divided into good prognosis group ( n =58) and poor prognosis group　( n =31) according to the prognosis．SAA，PCT，CRP and SOFA scores were detected and compared， and the efficiency of combined detection in the prediction of progno sis was analyzed．Results Compared with non-septic shock group，SAA(280.27±14.16 mg/L vs 251.87±25.20 mg/L)，CRP(105.74±23.5 7 mg/L vs 84.25±15.27 mg/L)，PCT(7.11±2.54 μg/L vs 3.34±1.84 μg/L) ，SOFA scores (9.03±2.37 vs 5.75±2.05) were significantly increased in septic shock group ( t =6.61，5.07，7.97，6.96，all P <0.001)．SAA (291.32±15.28　mg/L vs 242.35±24.88 mg/L)，PCT(7.28±2.69　μg/L vs 2.4 4±1.24 μg/L)，SOFA scores(9.16±2.25　vs 5.34±1.80) in poor prognosis group were significantly higher than those in good prognosis group ( t =11.27，10.77，8.81，all P <0.001)．SOFA score of patients with non-s eptic shock was positively correlated with SAA ( r=0.372，P =0.041) and PCT 　( r=0.354，P =0.047)， but no correlation with CRP　( r=0.289，P =0.07 1)．SOFA score　was positively correlated with SAA　( r=0.414，P =0.024)，CR P　( r=0.342，P =0.044) and PCT　( r=0.395，P =0.031) in patients with s eptic shock．The AUC　(0.96 vs　0.84，0.67，0.82)，sensitivity　(0.81±0.2 1 vs 0.78±0.20，0.60±0.22，0.75±0.25) and specificity (0.74±0.25 vs 0.72±0.24，0.63±0.17，0.71±0.28) of combined detection in predicting t he prognosis of patients with septic shock were significantly higher than those of SAA，PCT and PCR alone ( P <0.05)．Conclusion SAA， PCT and CRP are effective indicators for evaluating the severity and prognosis of septic shock．On the basis of SOFA，the combination of SAA，PCT and CRP may further improve the sensitivity of prognosis prediction of septic shock．

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备注/Memo

备注/Memo:
基金项目：上海市卫生和计划生育委员会项目(编号：2018 40314)。
作者简介：戴晓勇(1974-)，男，本科，主治医师，研究方向：急 诊及危重症方向，E-mail：xiaoyong_dai8@126.com。
通讯作者：石斌(1969-)，主任医师，E-mail：24639385@qq. com。
更新日期/Last Update: 2019-02-28