血清乳酸联合降钙素原检测用于 脓毒症致 急性呼吸窘迫 综合征.PDFVIP

浙江医学2018 年第40 卷第 1期 血清乳酸联合降钙素原检测用于 脓毒症致急性呼吸窘迫综合征 预后判断的价值 陈露 吴先龙 【摘要 】 目的 探讨血清乳酸和降钙素原（PCT ）水平用于各型脓毒症致急性呼吸窘迫综合征（ARDS ）预后判断的价值。方法 选取脓毒症致ARDS 45 例、严重脓毒症致ARDS 32 例、脓毒性休克致ARDS 19 例共96 例患者，在患者入院当天和死亡前分别采用 免疫化学发光法和化学分析法检测血清乳酸、PCT 水平，统计7d 内的病死率。采用ROC 曲线评估两种指标对ARDS 病 预后的诊断 效能。结果 血清乳酸和PCT 水平以脓毒性休克致ARDS 患者最高（P＜0.05 ），且死亡组患者的水平明显高于生存组，血清乳酸和 PCT 水平检测用于脓毒症致ARDS 预后判断的灵敏度和特异度分别为0.684 和0.854 ，0.895 和0.659。结论 血清PCT 和乳酸对 脓毒症致ARDS 病 严重程度的判断有一定价值，联合检测可以提高对预后判断的灵敏度和特异度。 【关键词】 急性呼吸窘迫综合征 脓毒症 乳酸 降钙素原 重症医学 Clinical significance of combination detection for serum lactic acid and procalcitonin levels in acute respiratory distress syndrome(ARDS) caused by sepsis China 【Abstract 】 Objective To investigate the clinical significance of serum lactic acid and procalcitonin levels in acute respiratory distress syndrome(ARDS) induced by sepsis. Methods Ninety six patients with ARDS induced by sepsis admitted in intensive care unit (ICU) from March 2013 to October 2015 were recruited. Serum lactic acid and procalcitonin levels were detected with chemical analysis and immune chemiluminescence method, respectively on the day of admission, after disease remission, or before the patients died. And the receiver-operating characteristic curve (ROC curve) was used to assess the diagnostic value of the two markers for ARDS. Results The serum levels of lactic acid and procalcitonin were positively associated with the severity of ARDS (P ＜0.05), the highest level was detected in ARDS induced by septic shock. The sensibility and specificity of serum lactic acid and procalcitonin were 0.684, 0.854, and 0.895 and 0.659 for assessing disease prognosis, respectively. Conclusion Serum lactic acid and procalcitonin have a certain value in asse