| 血清降钙素原用于烧伤脓毒症早期诊断的临床研究 |
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| 引用本文： | 刘兆兴,张改巾,刘佳颖,徐圣博,郑 波,申传安. 血清降钙素原用于烧伤脓毒症早期诊断的临床研究[J]. 现代生物医学进展, 2019, 19(6): 1069-1073 |
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| 作者姓名： | 刘兆兴 张改巾 刘佳颖 徐圣博 郑 波 申传安 |
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| 作者单位： | 解放军总医院第一附属医院烧伤整形科 |
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| 基金项目： | 国家自然科学基金面上项目(81373140)；全军后勤科研计划重点项目(BWS14J048) |
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| 摘 要： | 目的:分析特重度烧伤患者血清降钙素原(PCT)水平,探讨其在烧伤脓毒症早期诊断中的应用价值。方法:回顾性分析2014年1月至2018年1月解放军总医院第一附属医院烧伤整形科收治的259例特重度烧伤患者的病例资料,根据患者烧伤ICU住院期间是否发生脓毒症分为脓毒症组(86例,359个检测时间点)与非脓毒症组(173例,1591个检测时间点),收集患者年龄、性别、烧伤面积、烧伤深度、合并有吸入性损伤情况等一般资料,记录每个检测时间点的血常规、肝肾功、血气分析及血清PCT值等实验室检查结果。比较两组患者基线情况及各项脓毒症相关生物学指标,分析各项生物学指标脓毒症诊断能力及不同PCT截断值的诊断效能,并绘制受试者工作特征(ROC)曲线,评估各项生物学指标烧伤脓毒症的诊断效能。结果:两组体温、心率、呼吸频率、血小板计数、胆碱酯酶、脑钠肽差异无统计学意义(P0.05),脓毒症组血清PCT水平[4.52(2.35~8.83) vs 1.33(0.74~3.24)]、白细胞计数[24.28 (17.48~33.09) vs 20.11 (16.01~25.4)]、血糖[13.12 (9.66~17.28) vs 10.45 (8.31~13.13)]、肌酐[71.60 (57.94~89.62) vs 61.48(48.87~73.48)]、总胆红素差[30.07(22.63~38.69) vs 21.04(15.53~28.4)]显著高于非脓毒症组,差异有统计学意义(P0.05),其区分脓毒症与非脓毒症的ROC曲线下面积分别为0.801 (95%CI为0.776~0.824,P0.01)、0.617 (95%CI为0.581~0.652,P0.01)、0.658(95%CI为0.624~0.691,P0.01)、0.671(95%CI为0.640~0.702,P0.01)、0.722(95%CI为0.694~0.691,P0.01)。PCT的有效截断值为2.0 ng/mL(敏感度84.4%、特异度62.1%)、3.0 ng/m L(敏感度70.8%、特异度71.8%)、4.0 ng/m L(敏感度58.1%、特异度81.2%)。结论:PCT可作为烧伤脓毒症早期诊断的有效生物学指标。
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| 关 键 词： | 烧伤；脓毒症；早期诊断；降钙素原 |
| 收稿时间： | 2018-10-11 |
| 修稿时间： | 2018-10-31 |
Clinical Analysis of Serum Procalcitonin for the Early Diagnosis of Sepsis in Burn Patients |
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| LIU Zhao-xing,ZHANG Gai-jin,LIU Jia-ying,XU Sheng-bo,ZHENG Bo and SHEN Chuan-an. Clinical Analysis of Serum Procalcitonin for the Early Diagnosis of Sepsis in Burn Patients[J]. Progress in Modern Biomedicine, 2019, 19(6): 1069-1073 |
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| Authors: | LIU Zhao-xing ZHANG Gai-jin LIU Jia-ying XU Sheng-bo ZHENG Bo SHEN Chuan-an |
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| Affiliation: | Department of Burns and Plastic Surgery, First Hospital Affiliated to the People''s Liberation Army General Hospital, Beijing, 100048, China,Department of Burns and Plastic Surgery, First Hospital Affiliated to the People''s Liberation Army General Hospital, Beijing, 100048, China,Department of Burns and Plastic Surgery, First Hospital Affiliated to the People''s Liberation Army General Hospital, Beijing, 100048, China,Department of Burns and Plastic Surgery, First Hospital Affiliated to the People''s Liberation Army General Hospital, Beijing, 100048, China,Department of Burns and Plastic Surgery, First Hospital Affiliated to the People''s Liberation Army General Hospital, Beijing, 100048, China and Department of Burns and Plastic Surgery, First Hospital Affiliated to the People''s Liberation Army General Hospital, Beijing, 100048, China |
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| Abstract: | |
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| Keywords: | Burn Sepsis Diagnosis Procalcitonin |
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