烧伤早期伴发脓毒症患者血清PCT、hs-CRP、COR及WBC的动态变化及临床意义

目的:探讨烧伤早期伴发脓毒症患者血清降钙素原(PCT)、超敏C反应蛋白(hs-CRP)、皮质醇(COR)和白细胞计数(WBC)水平并分析其临床价值。方法:回顾性分析2014年12月至2018年1月本院收治的63例烧伤早期患者的临床资料,其中19例患者伴发脓毒症(脓毒症组),44例患者未伴发脓毒症(无脓毒症组),另选取30例于本院进行体检的志愿者作为健康对照组,依据病情严重程度将脓毒症患者分为脓毒症休克组(n=4)、严重脓毒症组(n=7)、一般脓毒症组(n=8),依据预后情况分为预后良好组(n=13)和预后不良组(n=6)。动态检测并对比所有研究对象血清PCT、hs-CRP、COR和WBC水平。结果:无脓毒症组、脓毒症组血清PCT、hs-CRP、COR和WBC水平高于健康对照组,且脓毒症组高于无脓毒症组(P<0.05)。烧伤后7 d、11 d、15 d,脓毒症组血清PCT、hs-CRP、COR和WBC水平均高于无脓毒症组(P<0.05)。脓毒症休克组血清PCT、hs-CRP、COR和WBC水平高于严重脓毒症组、一般脓毒症组,且严重脓毒症组患者高于一般脓毒症组患者(P<0.05)。预后不良组血清PCT、hs-CRP、COR和WBC水平高于预后良好组(P<0.05)。结论:血清PCT、hs-CRP、COR和WBC水平在烧伤早期伴发脓毒症患者中水平异常升高,与病情严重程度有关,上述指标对预后判断有一定的临床参考价值。

Dynamic Changes and Clinical Significance of Serum PCT, hs-CRP, COR and WBC in Early Burn Patients with Sepsis

ABSTRACT Objective: To investigate the serum levels of procalcitonin (PCT), hypersensitive C-reactive protein (hs-CRP), cortisol (COR) and white blood cell count (WBC) in early burn patients with sepsis and to analyze their clinical value. Methods: Clinical data of 63 cases of early burn patients admitted to our hospital from December 2014 to January 2018 were retrospective analysis, among them, 19 patients were accompanied by sepsis (sepsis group), and 44 patients were not accompanied by sepsis (non-sepsis group). Another 30 volunteers who underwent physical examination in our hospital were selected as healthy control group. The patients with sepsis were divided into septic shock group (n=4), severe sepsis group (n=7), general sepsis group (n=8) according to the severity of the illness. The patients were divided into good prognosis group(n=13) and poor prognosis group(n=6) according to the prognosis. The levels of serum PCT, hs-CRP, COR and WBC in all subjects were dynamically measured and compared. Results: Serum PCT, hs-CRP, COR and WBC levels in non-sepsis group and sepsis group were higher than those in healthy control group, and those in sepsis group were higher than those in non-sepsis group (P<0.05). The serum levels of PCT, hs-CRP, COR and WBC in sepsis group were higher than those in non-sepsis group at 7 d, 11 d and 15 d after burn(P<0.05). Serum PCT, hs-CRP, COR and WBC levels in septic shock group were higher than those in severe sepsis group and general sepsis group, and those in severe sepsis group patients were higher than those in general sepsis group(P<0.05). Serum PCT, hs-CRP, COR and WBC levels in poor prognosis group were higher than those in good prognosis group (P<0.05). Conclusion: The levels of serum PCT, hs-CRP, COR and WBC in early burn patients with sepsis abnormal increase, which is related to the severity of the disease, the above indicators have certain clinical reference value for prognosis.