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目的探讨动态监测血C反应蛋白(C reactire protein,CRP)和Wnt5a水平的相关变化对脓毒症患者诊疗的临床意义。方法选择2010-01/2014-02月作者科室收住的脓毒症患者15例,将15例脓毒症患者随机配对分为常规治疗组,常规治疗+胰岛素组,常规治疗+强化胰岛素组。在入科的第2,4,6,8天检测CRP及Wnt5a水平,同时行血培养,根据血培养结果分为血培养阳性组和血培养阴性组。结果在脓毒症血培养阳性组第2,4,6,8天,Wnt5a水平及第6,8天的CRP水平明显高于血培养阴性组;三组患者中CRP水平与Wnt5a随时间呈下降趋势,在ROC曲线中,Wnt5a有更好的敏感性和特异性。结论脓毒症患者血清Wnt5a水平较CRP水平与脓毒症严重程度有着更明显的相关性,动态监测Wnt5a水平变化有助于脓毒症严重程度的判断及临床治疗。
Objective To investigate the clinical significance of dynamically monitoring the changes of C reactire protein (CRP) and Wnt5a levels in diagnosis and treatment of septic patients. Methods Fifteen patients with sepsis admitted in the department from January 2010 to January 2014 were recruited. The 15 patients with sepsis were randomly assigned to conventional treatment group, conventional therapy plus insulin group, and conventional therapy plus intensive insulin group. On the 2nd, 4th, 6th and 8th day, the levels of CRP and Wnt5a were detected, and blood culture was performed at the same time. According to the result of blood culture, blood culture positive group and blood culture negative group were divided. Results On the 2nd, 4th, 6th and 8th days of sepsis positive blood culture group, the levels of Wnt5a and CRP on the 6th and 8th days were significantly higher than those in the negative blood culture group. The levels of CRP and Wnt5a in the three groups were decreased with time In the ROC curve, Wnt5a has better sensitivity and specificity. Conclusions Serum Wnt5a levels in sepsis patients have a more significant correlation with CRP levels and the severity of sepsis. The dynamic monitoring of Wnt5a levels may be helpful in judging the severity of sepsis and clinical treatment.