Tan Leming, Yang Cheng, Yang Xukai, Wang Yangmin, Cai Gaoping, Cao Zhigang, Huang Chuang, Xu Dongbo
Gansu University of Chinese Medicine, Lanzhou 730000, China.
Department of Urology, The 940th Hospital of Joint Logistics Support Force of Chinese People's Liberation Army, Lanzhou 730050, China.
Nan Fang Yi Ke Da Xue Xue Bao. 2019 Jan 30;39(1):93-99. doi: 10.12122/j.issn.1673-4254.2019.01.15.
To analyze the association of the clinical inflammatory indices with the severity of urinary sepsis.
We reviewed the clinical data of 70 patients with urinary sepsis treated in our hospital between January, 2013 and April, 2018. All the patients were diagnosed in line with the Guidelines for Diagnosis and Treatment of Urological Diseases in China (2014 edition), including 22 patients with sepsis, 12 with hypotension and severe sepsis, 17 with septic shock, and 19 with critical septic shock. White blood cell count (WBC), neutrophil percentage (N%), platelets (PLT), fibrinogen (FIB), Ddimer, interleukin-6 (IL-6), procalcitonin (PCT) and C-reactive protein (CRP) were examined in all the cases and compared among the 4 groups. The correlations of these inflammatory markers with the severity of sepsis were analyzed using logistic regression analysis.
The 4 groups of patients showed significant differences in N%, PLT, D-dimer, and PCT ( < 0.05) but not in CRP (>0.05). Kruskal-Wallis Pairwise comparisons showed that the N% and PCT in patients with sepsis differed significantly from those in the other 3 groups; platelets in patients with sepsis differed significantly from those in patients with septic shock and critical septic shock; D-dimer differed significantly between patients with sepsis and those with septic shock. Among the 4 groups, the median levels of PLT decreased and PCT and N% increased with the worsening of sepsis. Logistic regression analysis indicated that PCT (=0.186, =0.000), N% (=0.047, =0.035) and PLT (=-0.012, =0.003) were significantly correlated with the severity of sepsis in these patients.
PCT, PLT and N% are all significantly correlated with the severity of sepsis, and their combined detection can be informative for assessing the severity of sepsis to facilitate clinical decisions on treatment.
分析临床炎症指标与尿源性脓毒症严重程度的相关性。
回顾性分析2013年1月至2018年4月在我院治疗的70例尿源性脓毒症患者的临床资料。所有患者均符合《中国泌尿外科和男科疾病诊断治疗指南(2014版)》,其中脓毒症患者22例,脓毒症伴低血压和严重脓毒症患者12例,感染性休克患者17例,脓毒性休克患者19例。检测所有患者的白细胞计数(WBC)、中性粒细胞百分比(N%)、血小板(PLT)、纤维蛋白原(FIB)、D-二聚体、白细胞介素-6(IL-6)、降钙素原(PCT)和C反应蛋白(CRP),并在4组间进行比较。采用Logistic回归分析这些炎症标志物与脓毒症严重程度的相关性。
4组患者在N%、PLT、D-二聚体和PCT方面差异有统计学意义(<0.05),而在CRP方面差异无统计学意义(>0.05)。Kruskal-Wallis两两比较显示,脓毒症患者的N%和PCT与其他3组差异有统计学意义;脓毒症患者的血小板与感染性休克和脓毒性休克患者差异有统计学意义;脓毒症患者与感染性休克患者的D-二聚体差异有统计学意义。4组中,随着脓毒症病情加重,PLT中位数水平降低,PCT和N%升高。Logistic回归分析表明,PCT(=0.186,=0.000)、N%(=0.047,=0.035)和PLT(=-0.012,=0.003)与这些患者脓毒症的严重程度显著相关。
PCT、PLT和N%均与脓毒症的严重程度显著相关,联合检测有助于评估脓毒症的严重程度,为临床治疗决策提供参考。