C反应蛋白、降钙素原预测脓毒症患者撤机时机的价值评价.docVIP

C反应蛋白、降钙素原预测脓毒症患者撤机时机的价值评价 　　【摘要】 目的：应用受试者工作特征（ROC）曲线评价C反应蛋白（CRP）、降钙素原（PCT）预测脓毒症患者撤机时机的效能和价值。方法：纳入2012年10月-2013年8月笔者于北京协和医院ICU病房进修期间，112例有创机械通气的严重脓毒症或脓毒性休克患者。所有患者达到撤机标准，验血查CRP、PCT后依程序撤机，根据撤机结局分为撤机成功组和撤机失败组，比较组间CRP和PCT的差异，并绘制CRP、PCT与撤机结局的ROC曲线。结果：撤机前，撤机成功组CRP和PCT水平均较撤机失败组低，差异有统计学意义（P0.05）；CRP和PCT预测撤机成功的曲线下面积（AUC）分别为0.887和0.745，最佳Youden指数为0.71和0.48，对应的节点值分别为12.5 mg/L、3.55 μg/L。结论：CRP和PCT对撤机结局有一定预测价值，可作为脓毒症患者撤机时机的筛查指标。 　　【关键词】 C反应蛋白； 降钙素原； 脓毒症； 撤机； ROC曲线 　　中图分类号 R631 文献标识码 A 文章编号 1674-6805（2015）18-0003-03 　　Valuations of C-reaction Protein and Procalcitonin to Predict the Time Point of Weaning in Sepsis with Mechanical Ventilation/WANG Yu-e，YU Yuan.//Chinese and Foreign Medical Research，2015，13（18）：3-5 　　【Abstract】 Objective：To evaluate the predicted significance of C-reaction protein（CRP） and procalcitonin（PCT） in weaning outcome of patients with mechanical ventilation（MV） by the application of ROC curve.Method：112 ICU sepsis patients with mechanical ventilation were enrolled from October 2012 to August 2013 when the author was studying in the ICU of Peking Union Medical College Hospital.All patients met the clinical weaning criteria.Serum CRP and PCT levels were measured before weaning from MV.According to weaning outcome，all patients were divided into successful group and unsuccessful group，and the differences in levels of CRP and PCT were compared between the two groups.ROC curve for predicting weaning outcome was drawn to evaluate the prediction significance of serum CRP and PCT.Result：Serum levels of CRP and PCT before weaning in successful group were significantly lower than those of unsuccessful group（P0.05），corresponding area under the curve（AUC） was 0.887（CRP） and 0.745（PCT），and Youden’s index was 0.71（CRP） and 0.48（PCT）.Below the level of 12.5 mg/L（CRP） and 3.55 μg/L（PCT），the success rate of weaning from MV was highest respectively.Conclusion：The serum CRP and PCT value before weaning have certain predictive values on weaning outcome，and can be used