4.18.降钙素原、新蝶呤与乳酸对脓毒血症患者预后评估临床价值研究(改).docVIP

降钙素原、新蝶呤与乳酸对脓毒血症患者预后评估的临床价值研究 温海洋 李少洪 钟坚 王存 龙珍中山大学附属东华医院 523110 摘要：目的：探讨在脓毒血症患者预后评估中，降钙素原、新喋呤及乳酸的临床价值。方法：选取95例脓毒血症患者，随机分成2组，其中生存组65例，死亡组30例，将发病早期的降钙素原、新喋呤与乳酸水平和APACHEⅡ评分进行对比，通过建立ROC曲线探讨标记物对于预后评估的临床意义。结果：通过对比数据发现，2组患者在降钙素原、新喋呤与乳酸水平及APACHEⅡ评分方面有明显的差异，降钙素原、新喋呤与乳酸水平与APACHEⅡ评分相关性明显；病死率与标记物阳性结果的出现率成正比。结论：在脓毒血症患者的预后评估过程中，降钙素原、新喋呤与乳酸具有重要价值，能够对患者的死亡产生较好的预测意义，同时，通过进行联合检测能够有效提高预测的准确程度。 关键词：降钙素原、新喋呤、乳酸、脓毒血症、预后 Clinical value of procalcitonin, neopterin and lactic acid on the prognosis of patients with sepsis Wen Haiyang; Li Shaohong; Zhong Jian; Wang Cun; Long Zhen, Donghua Hospital Affiliated to Zhongshan University 523110 Abstract: Objective: Analysis of procalcitonin, neopterin and lactic acid on the prognosis of patients with sepsis clinical value. Methods: The prognosis of 95 cases of sepsis patients were randomly divided into survival group and death group, which the survival of the group of 65 patients, 30 patients were dead group, the incidence of early procalcitonin, neopterin and lactic acid levels and APACHE Ⅱ ratings were compared to investigate the clinical significance of markers for prognostic assessment through the establishment of the ROC curve. Results: The analysis showed that the level and APACHE Ⅱ score of three kinds of markers with a significant difference in the 2 groups of patients, and three kinds of markers and APACHE Ⅱ score has a significant correlation, the markers positive results more, higher mortality, three markers to predict death ROC area were under the curve of 0.70 to 0.78. Conclusion: procalcitonin, neopterin and lactic acid on the prognosis of the patients with sepsis has important clinical research value of death in patients with a better forecast, and joint detection can improve the degree of sensitivity of the forecast. Keywords: procalcitonin, neopterin, lactic acid, sepsis, prognosis, APACHE Ⅱ score 脓毒血症（sepsis）通常是由感染引起，表现为一种全身炎症反应的综合征（systemic inflammatory response syndrome, SIRS），临床观察证实存在高度可疑感染灶及细菌。脓毒血症发生后，一般遵循其自身的病理发展过程和发生规律，所