炎症因子对感染致脓毒症患者的诊断价值

Diagnostic value of inflammatory factors in patients with sepsis caused by infections

  • 摘要: 目的 探究炎症因子对感染致脓毒症患者的诊断价值。方法 选取2015年1月-2017年6月医院ICU脓毒症患者130例为研究对象,设为试验组,选取同期非脓毒症患者106例为对照组,比较两组患者外周血降钙素原(PCT)、血清游离钙离子、C-反应蛋白(CRP)、N端前脑钠肽(NT-proBNP)及血浆D-二聚体(D-D),并对其与脓毒症的相关性进行分析。结果 试验组PCT、NT-proBNP及CRP水平分别为(27.34±10.82)ng/L、(3652.39±431.26)pg/ml和(125.53±24.66)mg/L高于对照组(10.31±4.50)ng/L、(823.43±109.71)pg/ml和(58.32±11.25)mg/L(P<0.05);脓毒症患者共检出病原菌130株,其中革兰阴性菌68株占52.31%,以大肠埃希菌、拟杆菌为主;革兰阳性菌35株占26.92%,以金黄色葡萄球菌、表皮葡萄球菌为主;真菌22株占16.92%,以白假丝酵母、曲霉菌为主;脓毒症患者的PCT、NT-proBNP及游离钙离子与APACHEⅡ评分呈现相关性(P<0.05),PCT与APACHEⅡ呈强相关性。结论 PCT及NT-proBNP有助于脓毒症的早期诊断,PCT和血清游离钙离子能作为评价脓毒症严重程度的重要指标。

     

    Abstract: OBJECTIVE To investigate the diagnostic value of inflammatory cytokines in patients with sepsis caused by infections. METHODS A total of 130 patients with sepsis in the hospital ICU from Jan. 2015 to Jun. 2017 were selected as experimental group, and 106 patients with non-sepsis in the same period were selected as control group. Peripheral blood procalcitonin (PCT), serum free calcium, C-reactive protein (CRP), N-terminal pro-brain natriuretic peptide (NT-proBNP) and plasma D-dimer (DD) were compared between the two groups, and their correlation with sepsis was analyzed. RESULTS The levels of PCT, NT-proBNP and CRP in experimental group were (27.34±10.82) ng/L, (3652.39±431.26) pg/ml and (125.53±24.66) mg/L, respectively, which were higher than (10.31±4.50) ng/L, (823.43±109.71) pg/ml and (58.32±11.25) mg/L (P<0.05). A total of 130 pathogenic bacteria were detected in septic patients, of which 68 were gram-negative bacteria accounting for 52.31%, mainly Bacillus subtilis and Bacteriocin,35 strains were gram-positive bacteria accounting for 26.92%, mainly Staphylococcus aureus and Staphylococcus epidermidis, and 22 strains were fungi accounting for 16.92%, mainly Candida albicans and Aspergillus. The levels of PCT, NT-proBNP and free calcium in the sepsis group were correlated with APACHEⅡscore (P<0.05), and PCT was strongly correlated with APACHEⅡ. CONCLUSION PCT and NT-proBNP contribute to the early diagnosis of sepsis. PCT and serum free calcium can be used as important indexes to evaluate the severity of sepsis.

     

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