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血清降钙素原在脓毒症中的意义。

Significance of serum procalcitonin in sepsis.

作者信息

Sudhir Uchil, Venkatachalaiah Ravi Kumar, Kumar Thimmaiah Anil, Rao Medha Yogesh, Kempegowda Punith

机构信息

Department of Medicine, M S Ramaiah Hospitals, MSRIT Post, New BEL Road, Bangalore, India.

出版信息

Indian J Crit Care Med. 2011 Jan;15(1):1-5. doi: 10.4103/0972-5229.78214.

Abstract

CONTEXT

Rapid treatment of sepsis is of crucial importance for survival of patients. Specific and rapid markers of bacterial infection have been sought for early diagnosis of sepsis. One such measurement, Procalcitonin (PCT), has recently become of interest as a possible marker of the systemic inflammatory response to infection.

AIMS

This study was done to find out the common sources of sepsis and to evaluate the diagnostic value of PCT, its predictive value and its relation with Sepsis-related Organ Failure Assessment (SOFA) scores and mortality in various stages of sepsis.

SETTINGS AND DESIGN

The prospective study was conducted at our tertiary care center from October 2006 to December 2008. A total of 100 patients were included in the study. The study sample included all patients aged above 18 years presenting consecutively to our center during the study period with acute sepsis. They were divided into three groups: sepsis, severe sepsis and septic shockbased on standardized criteria.

MATERIALS AND METHODS

PCT and various other relevant factors were measured in all study subjects. These parameters were compared among the three study groups. The statistical analyses were done using Student "t" test and two-way analysis of variance (ANOVA).

RESULTS

Respiratory tract infection was the most common source of sepsis. PCT proved to be an excellent indicator of sepsis with sensitivity of 94%. There was a significant association between serum PCT and SOFA scores (P < 0.05). Serum PCT levels did not predict mortality in the present study.

CONCLUSIONS

PCT is among the most promising sepsis markers, capable of complementing clinical signs and routine lab parameters suggestive of severe infection.

摘要

背景

脓毒症的快速治疗对患者的生存至关重要。人们一直在寻找细菌感染的特异性快速标志物,用于脓毒症的早期诊断。降钙素原(PCT)这一检测指标最近作为感染引起的全身炎症反应的一种可能标志物而受到关注。

目的

本研究旨在找出脓毒症的常见来源,评估PCT的诊断价值、预测价值及其与脓毒症相关器官功能衰竭评估(SOFA)评分以及脓毒症各阶段死亡率的关系。

设置与设计

这项前瞻性研究于2006年10月至2008年12月在我们的三级医疗中心进行。共有100名患者纳入研究。研究样本包括在研究期间连续到我们中心就诊的所有18岁以上急性脓毒症患者。根据标准化标准,他们被分为三组:脓毒症组、严重脓毒症组和脓毒性休克组。

材料与方法

对所有研究对象测量PCT及其他各种相关因素。在三个研究组之间比较这些参数。采用Student "t"检验和双向方差分析(ANOVA)进行统计分析。

结果

呼吸道感染是脓毒症最常见的来源。PCT被证明是脓毒症的一个优秀指标,敏感性为94%。血清PCT与SOFA评分之间存在显著关联(P < 0.05)。在本研究中,血清PCT水平不能预测死亡率。

结论

PCT是最有前景的脓毒症标志物之一,能够补充提示严重感染的临床体征和常规实验室参数。

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