[1]曹 双.动态监测乳酸、PCT、CRP对ICU脓毒症-3患者预后的价值[J].医学信息,2021,34(16):95-97,101.[doi:10.3969/j.issn.1006-1959.2021.16.025]
 CAO Shuang.The Value of Dynamic Monitoring of Lactate, PCT and CRP on the Prognosis of Patients with Sepsis-3 in ICU[J].Medical Information,2021,34(16):95-97,101.[doi:10.3969/j.issn.1006-1959.2021.16.025]
点击复制

动态监测乳酸、PCT、CRP对ICU脓毒症-3患者预后的价值()
分享到:

医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
34卷
期数:
2021年16期
页码:
95-97,101
栏目:
论著
出版日期:
2021-08-15

文章信息/Info

Title:
The Value of Dynamic Monitoring of Lactate, PCT and CRP on the Prognosis of Patients with Sepsis-3 in ICU
文章编号:
1006-1959(2021)16-0095-04
作者:
曹 双
(天津市滨海新区海滨人民医院呼吸与危重症医学科,天津 300280)
Author(s):
CAO Shuang
(Department of Respiratory and Critical Care Medicine,Haibin People’s Hospital of Tianjin Binhai New Area,Tianjin 300280,China)
关键词:
动脉血乳酸PCTCRP脓毒症-3预后
Keywords:
Arterial blood lactic acidPCTCRPSepsis-3Prognosis
分类号:
R631
DOI:
10.3969/j.issn.1006-1959.2021.16.025
文献标志码:
A
摘要:
目的 探讨动脉血乳酸、PCT、C-反应蛋白水平对ICU脓毒血症-3患者预后的预测价值。方法 选取我院2020年1月~12月ICU收治的脓毒症-3患者84例,按照预后分为死亡组37例,存活组47例,分别比较两组入院时、12、24、36、48 h、转出(或死亡)当天乳酸水平及入住ICU第1、3、7天及转出(或死亡)当天PCT、CRP水平,采用受试者工作特征曲线(ROC)分析其对脓毒症-3患者预后的预测价值。结果 死亡组观察期间乳酸水平、入院第7天及死亡当天PCT、CRP水平高于存活组,差异有统计学意义(P<0.05)。ROC曲线分析显示:血乳酸AUC为0.83,最佳阈值为1.55 mmol/L,约登指数为0.52时,敏感度为83.30%,特异度为68.40%;入院第7天AUCPCT为0.79,最佳阈值为0.57 ng/ml,约登指数为0.52时,敏感度为75.00%,特异度为76.90%;转出或死亡当天AUCCRP为0.83,最佳阈值为56.68 mg/L,约登指数为0.76时,敏感度为87.50%,特异度为88.90%。结论 动态监测动脉血乳酸、PCT、CRP水平对于改善脓毒症-3患者预后,提高患者生存质量,提高生存率具有重要意义。
Abstract:
Objective To explore the predictive value of arterial blood lactate, PCT, and C-reactive protein levels in the prognosis of ICU patients with sepsis-3.Methods A total of 84 patients with sepsis-3 who were admitted to the ICU in our hospital from January to December 2020 were selected.According to the prognosis, they were divided into 37 cases in the death group and 47 cases in the survival group.The lactic acid levels at admission, 12, 24, 36, 48 h, the day of transfer (or death), and the levels of PCT and CRP on the first, 3, and 7 d of ICU admission and the day of transfer (or death) were compared between the two groups respectively.The receiver operating characteristic curve (ROC) was used to analyze its predictive value for the prognosis of patients with sepsis-3.Results The levels of lactate in the observation period, PCT and CRP levels on the 7th d of admission and the day of death in the death group were higher than those in the survival group,the differences were statistically significant (P<0.05).ROC curve analysis showed that: blood lactate AUC was 0.83, the best threshold was 1.55 mmol/L, and the Youden index was 0.52, the sensitivity was 83.30%, and the specificity was 68.40%;On the 7th d of admission, the AUCPCT was 0.79, the optimal threshold was 0.57 ng/ml, and the Youden index was 0.52, the sensitivity was 75.00%, and the specificity was 76.90%;The AUCCRP on the day of transfer or death was 0.83, the optimal threshold was 56.68 mg/L, and the Youden index was 0.76, the sensitivity was 87.50%, and the specificity was 88.90%.Conclusion Dynamic monitoring of arterial blood lactate, PCT, and CRP levels is of great significance for improving the prognosis of patients with sepsis-3, improving the quality of life of patients, and improving the survival rate.

参考文献/References:

[1]Erin D.Sepsis[J].Nursing Management,2016,30(23):17. [2]中国医师协会急诊医师分会,中国研究型医院学会休克与脓毒症专业委员会.中国脓毒症/脓毒性休克急诊治疗指南(2018)[J].临床急诊杂志,2018,19(9):567-588. [3]中华医学会重症医学分会,严静.中国严重脓毒症/脓毒性休克治疗指南(2014)[J].中华内科杂志,2015(6):557-581. [4]Zhu Y,Yin H,Zhang R,et al.Varying Presentations and Outcomes of Septic Shock:Should Septic Shock Be Stratified[J].Randomized Controlled Trial Am Surg,2017,83(11):1235-1240. [5]何美娜,招晓俊.血乳酸水平和乳酸清除率评估脓毒血症的预后研究[J].解放军预防医学杂志,2019,37(1):92-94. [6]许世琴,贾安奎,徐爱华,等.乳酸清除率在脓毒症病情判断及预后评估的应用效果分析[J].中华医院感染学杂志,2017,27(5):996-999. [7]Wang J,Wang H,Liu W,et al.Assessment values of procalcitonin, lactic acid, and disease severity scores in patients with sepsis[J].Chinese Critical Care Medicine,2019,31(8):938-941. [8]Jekarl DW,Lee S,Kim M,et al.Procalcitonin as a prognostic marker for sepsis based on SEPSIS-3[J].Journal of Clinical Laboratory Analysis,2019,33(9):e22996. [9]牛亚楠.脓毒血症患者血清降钙素原水平变化及临床意义[J].中外医学研究,2015(14):68-68,69. [10]Contenti J,Occelli C,Lemoel F,et al.Presepsin versus other biomarkers to predict sepsis and septic shock in patients with infection defined by Sepsis-3 criteria:the PREDI study of diagnostic accuracy[J].Emergencias,2019,31(5):311-317. [11]Zhao M,Duan M.Lactic acid,lactate clearance and procalcitonin in assessing the severity and predicting prognosis in sepsis[J].Chinese Critical Care Medicine,2020,32(4):449-453. [12]Yu H,Nie L,Liu A,et al.Combining procalcitonin with the qSOFA and sepsis mortality prediction[J].Medicicne,2019,98(23):e15981.

相似文献/References:

[1]张 洁.WBC、CRP和PCT在急诊发热患者诊治中的应用[J].医学信息,2018,31(07):157.[doi:10.3969/j.issn.1006-1959.2018.07.055]
 ZHANG Jie.Application of WBC,CRP and PCT in Diagnosis and Treatment of Emergency Fever Patients[J].Medical Information,2018,31(16):157.[doi:10.3969/j.issn.1006-1959.2018.07.055]
[2]吴丕六,汤 磊.PCT、IL-6和CRP水平预测未足月胎膜早破患者并发绒毛膜羊膜炎及新生儿早发性败血症的价值研究[J].医学信息,2019,32(04):163.[doi:10.3969/j.issn.1006-1959.2019.04.054]
 WU Pi-liu,TANG Lei.PCT, IL-6 and CRP Levels Predict the Value of Chorioamnionitis and Early Onset Sepsis in Patients with Premature Rupture of Fetal Membranes[J].Medical Information,2019,32(16):163.[doi:10.3969/j.issn.1006-1959.2019.04.054]
[3]易晓明,曾 芬.甲泼尼龙治疗SCAP的效果及其对降钙素原水平的影响[J].医学信息,2019,32(21):145.[doi:10.3969/j.issn.1006-1959.2019.21.047]
 YI Xiao-ming,ZENG Fen.Effect of Methylprednisolone on SCAP and its Effect on Procalcitonin Level[J].Medical Information,2019,32(16):145.[doi:10.3969/j.issn.1006-1959.2019.21.047]
[4]周雯雯.支原体肺炎与细菌性肺炎炎性指标及血清降钙素原水平比较[J].医学信息,2020,33(02):169.[doi:10.3969/j.issn.1006-1959.2020.02.054]
 ZHOU Wen-wen.Comparison of Inflammatory Indexes and Serum Procalcitonin Levels in Mycoplasma Pneumonia and Bacterial Pneumonia[J].Medical Information,2020,33(16):169.[doi:10.3969/j.issn.1006-1959.2020.02.054]
[5]朱郁飞,陈 恳,谢美丽,等.PCT、ALB预测急性胰腺炎严重程度的价值[J].医学信息,2020,33(11):163.[doi:10.3969/j.issn.1006-1959.2020.11.053]
 ZHU Yu-fei,CHEN Ken,XIE Mei-li,et al.The Value of PCT and ALB in Predicting the Severity of Acute Pancreatitis[J].Medical Information,2020,33(16):163.[doi:10.3969/j.issn.1006-1959.2020.11.053]
[6]张凯新,杨林瀛.不同嗜酸性粒细胞水平的慢性阻塞性肺疾病急性加重期患者临床分析[J].医学信息,2021,34(08):85.[doi:10.3969/j.issn.1006-1959.2021.08.022]
 ZHANG Kai-xin,YANG Lin-ying.Clinical Analysis of Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease with Different Levels of Eosinophils[J].Medical Information,2021,34(16):85.[doi:10.3969/j.issn.1006-1959.2021.08.022]
[7]蔡文斌.阿莫西林克拉维酸钾联合雾化吸入治疗小儿支气管肺炎的效果及对PCT、CRP的影响[J].医学信息,2022,35(19):68.[doi:10.3969/j.issn.1006-1959.2022.19.018]
 CAI Wen-bin.Effect of Amoxicillin and Clavulanate Potassium Combined with Aerosol Inhalation on Children with Bronchial Pneumonia and Its Influence on PCT and CRP[J].Medical Information,2022,35(16):68.[doi:10.3969/j.issn.1006-1959.2022.19.018]

更新日期/Last Update: 1900-01-01