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大面积烧伤后早期血清降钙素原升高:影响因素及临床意义

Elevated serum procalcitonin early after extensive burn: influencing factors and clinical significance.

作者信息

Xu Long, Jin Jian, Wu Guosheng, Chen Tiansheng, Xu Dayuan, Zhu Feng, Xiao Shichu, Xia Zhaofan, Wang Guangyi

机构信息

Center of Burns and Trauma, Changhai Hospital, Naval Medical University, 168 Changhai Road, Shanghai 200433, PR China.

Center of Burns and Trauma, Changhai Hospital, Naval Medical University, 168 Changhai Road, Shanghai 200433, PR China.

出版信息

Burns. 2021 Sep;47(6):1399-1407. doi: 10.1016/j.burns.2020.12.010. Epub 2020 Dec 11.

Abstract

The study was carried out to analyze the factors influencing the elevated serum procalcitonin (PCT) levels during the early phase of extensive burn, and to investigate its potential for sepsis prediction and prognosis. Clinical data of 324 patients with extensive burns treated at our department from July 2014 to December 2019 were retrospectively analyzed. Approximately half of the patients (50.93%) exhibited elevated serum PCT concentrations during the early phase, and elevated PCT levels may not be caused by infections. Early-phase PCT level was an independent risk factor for sepsis occurrence in extensive-burn patients within 60 days of injury. Burn index, degree of inhalation injury, and APACHE-II score influenced PCT level elevation during the early phase. Patient age, burn index, APACHE-II score at admission, early-phase PCT level, and sepsis occurrence were risk factors for mortality in extensive-burn patients. During the early phase, approximately 50.93% of the extensive-burn patients exhibited elevated PCT levels, which were associated with non-infectious factors. As elevated PCT level during the early phase predicted sepsis occurrence within 60 days of injury and was significantly associated with patient mortality, it might be a potential burn severity indicator during the early phase of burn injury.

摘要

本研究旨在分析大面积烧伤早期血清降钙素原(PCT)水平升高的影响因素,并探讨其对脓毒症预测及预后判断的价值。回顾性分析了2014年7月至2019年12月在我科治疗的324例大面积烧伤患者的临床资料。约半数患者(50.93%)在早期血清PCT浓度升高,且PCT水平升高可能并非由感染引起。早期PCT水平是大面积烧伤患者伤后60天内发生脓毒症的独立危险因素。烧伤指数、吸入性损伤程度及急性生理与慢性健康状况评分系统(APACHE-II)评分影响早期PCT水平升高。患者年龄、烧伤指数、入院时APACHE-II评分、早期PCT水平及脓毒症发生情况是大面积烧伤患者死亡的危险因素。在早期,约50.93%的大面积烧伤患者PCT水平升高,这与非感染因素有关。由于早期PCT水平升高可预测伤后60天内脓毒症的发生,且与患者死亡率显著相关,故其可能是烧伤早期潜在的烧伤严重程度指标。

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