不同分级及转归脓毒症患者血清PCT、D-D、CRP及血小板相关参数检测的临床意义

目的:探讨不同分级及转归脓毒症患者的血清降钙素原(PCT)、D-二聚体(D-D)、C反应蛋白(CRP)及血小板相关参数检测的临床意义。方法:回顾性分析2015年3月至2018年8月期间中国人民解放军西部战区总医院收治的92例脓毒症患者的临床资料,分析不同分级及转归脓毒症患者的血清中PCT、D-D和CRP水平、急性病生理与慢性健康评价系统Ⅱ(APACHEⅡ)评分及血小板相关参数[血小板计数(PLT)、血小板平均容积(MPV)、血小板分布宽度(PDW)、大型血小板比率(P-LCR)],并分析脓毒症患者PCT、D-D、CRP水平以及血小板相关参数与APACHEⅡ评分的相关性。结果:全身炎症反应综合征组、轻度脓毒症组、严重脓毒症组、脓毒性休克组血清PCT、D-D和CRP水平、MPV、PDW、P-LCR、APACHEⅡ评分逐渐升高(P0.05),PLT逐渐降低(P0.05)。存活组患者血清PCT、D-D、CRP水平、MPV、PDW、P-LCR、APACHEⅡ评分均低于死亡组(P0.05),PLT高于死亡组(P0.05)。Pearson相关分析显示,脓毒症患者血清PCT、D-D、CRP、MPV、PDW、P-LCR与APACHE II评分呈正相关(P0.05),PLT与APACHE II评分呈负相关(P0.05)。结论:脓毒症患者血清PCT、D-D、CRP及血小板相关指标可能参与了脓毒症的发展,通过检测其血清PCT、D-D、CRP水平及血小板相关参数可评估脓毒症患者的病情和预后。

Clinical Significance of Serum PCT, D-D, CRP and Platelet-related Parameters in Sepsis Patients with Different Grades and Prognosis

ABSTRACT Objective: To investigate the clinical significance of serum procalcitonin (PCT), D-dimer (D-D), C-reactive protein (CRP) and platelet parameters in sepsis patients with different grades and prognosis. Methods: The clinical data of 92 patients with sepsis who were admitted to General Hospital of the Western War Zone of the Chinese People''s Liberation Army from March 2015 to August 2018 were retrospectively analyzed. The levels of serum PCT, D-D and CRP, acute physiology and chronic health evaluation II (APACHE II) score and platelet-related parameters [(platelet count (PLT), mean platelet volume (MPV), platelet distribution width (PDW), platelet-large platelet ratio (P-LCR)] in patients with sepsis of different conditions and different prognosis were analyzed.The correlation between PCT, D-D, CRP levels, platelet-related parameters and APACHE II score in sepsis patients were analyzed. Results: The levels of serum PCT, D-D and CRP, MPV, PDW, P-LCR and APACHE II in systemic inflammatory response syndrome group, mild sepsis group, severe sepsis group and septic shock group increased gradually (P<0.05). PLT decreased gradually (P<0.05). The levels of serum PCT, D-D, CRP, MPV, PDW, P-LCR and APACHE II in survival group were lower than those in death group (P<0.05). PLT was higher than that in the death group (P<0.05). Pearson correlation analysis showed that serum PCT, D-D, CRP, MPV, PDW, P-LCR were positively correlated with APACHE II score in patients with sepsis (P<0.05). PLT was negatively correlated with APACHE II score (P<0.05). Conclusion: The serum PCT, D-D, CRP and platelet-related parameters may be involved in the development of sepsis. Serum PCT,D-D, CRP levels and platelet-related parameters can be used to evaluate the condition and prognosis of sepsis patients.