蒋建红,刘文明,陈琦,谈铁武,孟丽君,霍中雷,汤艳.降钙素原及C反应蛋白水平在重症肺炎患者预后中的作用[J].内科急危重症杂志,2015,21(6):
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| DOI： |
| 中文关键词: 降钙素原 C反应蛋白 重症肺炎 预后 |
| 英文关键词:procalcitonin C-reactionprotein severe pneumonia prognostic value |
| 基金项目:] 常州市科技计划项目(ＷＺ２０１０ ２１) |
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| 中文摘要: |
| 目的：探讨降钙素原（Procalcitonin，PCT）及C反应蛋白水平（C-reactionprotein，CRP）在重症肺炎患者预后判断及转归中的作用 方法：2012年2月-2014年12月，回顾性分析我科收治重症肺炎患者65例，按照预后情况分为死亡组和存活组，对比分析两组间的临床一般特征、入院治疗前、48h、72h、出院前或死亡前PCT、CRP水平及APACHEⅡ评分 结果：两组患者PCT、CRP水平均较正常值明显升高，其中死亡组PCT 、CRP水平较存活组明显提高（P<0.01）。通过连续监测PCT、CRP水平发现抗生素使用有效时PCT水平明显降低，而CRP水平下降速度较PCT明显降低。血清 PCT 水平与APACHEⅡ评分的相关系数为 0.689，其相关性均高于CRP。PCT、CRP水平的升高与患者死亡具有相关性，OR值( 95% CI)分别为 2.9 (1.2- 7.8 )、7.4( 3.5 ~ 18.7) (P=0.003,0.001 )。结论：PCT、CRP水平在重症肺炎患者预后判断及转归中具有较好的作用，其中PCT水平监测效果优于CRP水平。 |
| 英文摘要: |
| Objective: To detective the prognostic value of procalcitonin and C-reactionprotein in patients with severe pneumonia Methods: From Feb. 2012-Dec. 2014, 65 patients with severe pneumonia were retrospectively analysised and randomly divided into two groups (survivors and non-survivors groups). The clinical characters, Levels of PCT and CRP, and APACHEⅡscore in pre- and post-therapy 48h、72h and before discharge. Results: All patients were got followed-up. The level of PCT and CRP increased significantly, and the level increased more in survivors group than non-survivors group (P<0.01). The level of PCT and CRP declined significantly when antibiotic used effectively, and the level of PCT declined faster than the level of CRP. The serum PCT levels with APACHE II score correlation coefficients was 0.689, and its relevance was higher than CRP. Increasing trend of PCT and CRP were associated with mortality, and the OR值( 95% CI) were 2.9 (1.2- 7.8 )、7.4( 3.5 ~ 18.7) (P=0.003, 0.001 ). Conclusion: The level of PCT and CRP reflect the severity of patients with severe pneumonia, and the PCT has better prognostic value. |
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