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目的:研究肺炎合并脓毒症患者血清超敏C反应蛋白(hs CRP)、降钙素原(PCT)水平的变化及其临床意义。方法:选择2012年2月~2015年12月在我院进行诊治的肺炎合并脓毒症患者80例,按照病情分为轻度脓毒症组28例,重度脓毒症组29例和脓毒性休克组23例,并选择20例同期进行体检健康者为对照组。同时按照患者2周内的存活情况分为死亡组和存活组。检测血清hs CRP、PCT水平,并进行急性生理学与慢性健康状况评分(APACHE)。结果:与对照组相比,三组脓毒症患者的血清hs CRP、PCT水平和APACHEⅡ评分均明显升高(P<0.05);且随着脓毒症患者病情的加重,血清PCT水平和APACHEⅡ评分依次升高,差异均有统计学意义(P<0.05);与存活组相比,死亡组的血清hs CRP、PCT水平均明显升高(P<0.05);Logistic回归分析结果表明,在控制了性别、年龄和其他因素后,血清hs CRP(OR=1.256,P<0.05)、PCT(OR=1.132,P<0.05)水平的升高是引起脓毒症患者死亡的独立危险因素。结论:肺炎合并脓毒症患者血清hs CRP、PCT水平均呈高表达状态,可以作为肺炎合并脓毒血症患者的病情严重程度以及预后的评价指标。
Objective: To study the changes of serum hs-CRP and procalcitonin (PCT) in patients with pneumonia complicated with sepsis and its clinical significance. Methods: 80 patients with pneumonia complicated with sepsis who were diagnosed and treated in our hospital from February 2012 to December 2015 were divided into mild sepsis group (n = 28), severe sepsis group (n = 29) and septic Shock group of 23 patients, and select 20 cases of physical examination at the same period as the control group. At the same time according to the patient’s survival within 2 weeks is divided into death group and survival group. Serum hs CRP, PCT levels were measured and acute physiology and chronic health assessment (APACHE) were performed. Results: Compared with the control group, serum hsCRP, PCT levels and APACHEⅡscores in three groups of sepsis patients were significantly increased (P <0.05); and with the aggravation of sepsis patients, serum PCT levels and APACHEⅡ (P <0.05). Compared with the survival group, the serum hs CRP and PCT levels in the death group were significantly increased (P <0.05). Logistic regression analysis showed that in the control Sex, age and other factors, serum hs CRP (OR = 1.256, P <0.05), PCT (OR = 1.132, P <0.05) increased the risk of death in patients with sepsis an independent risk factor. Conclusion: The serum hs CRP and PCT levels in patients with pneumonia complicated with sepsis are highly expressed, which can be used as the severity of the patients with pneumonia complicated with sepsis and prognostic indicators.