王玉珍　白　奎　杨　超　张春民　张二辉　高海波

河南大学第一附属医院重症医学科，河南开封475000

血清CRP及PCT在诊断细菌性脓毒症中的应用价值

王玉珍白奎杨超张春民张二辉高海波

河南大学第一附属医院重症医学科，河南开封475000

目的探讨血清CRP及PCT在诊断细菌性脓毒症中的应用价值。方法选择2013年1月～2016年4月在我院治疗的脓毒症患者54例以及局部感染患者62例为研究对象。另选择非感染患者60例为对照组。比较三组血清CRP及PCT水平、APACHEⅡ评分以及SOFA评分，比较脓毒症死亡亚组及存活亚组不同时间点CRP及PCT水平。结果脓毒症组及局部感染组PCT、CRP、APACHEⅡ评分以及SOFA评分均显著高于对照组，差异有高度统计学意义（P＜0.01）。脓毒症组PCT阳性率及CRP阳性率均显著高于局部感染组，差异具有高度统计学意义（P＜0.01）。脓毒症患者生存亚组随着治疗时间的延长，血清CRP水平呈下降趋势（P＜0.01），而死亡亚组无下降趋势；死亡亚组CRP在第1天、第5天、第10天及第15天均显著高于生存亚组，差异有高度统计学意义（P＜0.01）。脓毒症患者生存亚组随着治疗时间的延长，血清PCT水平呈下降趋势（P＜0.01），而死亡亚组无下降趋势。死亡亚组PCT在第1天、第5天、第10天及第15天均显著高于生存亚组，差异有高度统计学意义（P＜0.01）。结论细菌性脓毒症患者血清CRP及PCT水平均显著升高，并且死亡患者的水平更高。

C反应蛋白；降钙素原；细菌；脓毒症

［Abstract］Objective To discuss application value of serum CRP and PCT in the diagnosis of bacterial sepsis.Methods A total of 54 cases with sepsis and 62 cases with local infection in our hospital from January 2013 to April 2016 were selected as the research objects.Another 60 cases of non infected patients were selected as control group.Serum levels of CRP and PCT，APACHEⅡscore and SOFA score of three groups were compared.CRP and PCT levels in different time points of death subgroup and survival subgroup were compared.Results PCT，CRP，APACHEⅡscore and SOFA score of sepsis group and local infection group were higher than control group（P＜0.01）.The positive rate of PCT and the positive rate of CRP of the sepsis group were higher than the local infection group（P＜0.01）.In patients with survival subgroup of sepsis，the serum CRP level was decreased with the prolongation of treatment time（P＜0.01）；And that was not decreased in the death subgroup；That in the death subgroup was higher than in the survival subgroup on the first day，fifth day，tenth day and 15th day（P＜0.01）.In patients with survival subgroup of sepsis，PCT level was decreased with the prolongation of treatment time（P＜0.01）；And that was not decreased in the death subgroup；That in the death subgroup was higher than in the survival subgroup on the first day，fifth day，tenth day and 15th day（P＜0.01）. Conclusion The levels of serum CRP and PCT are significantly increased in patients with bacterial sepsis，and the levels of the patients with bacterial sepsis are higher.

［Key words］CRP；PCT；Bacterial；Sepsis

早期诊断脓毒症对及时治疗、改善患者预后具有重要的临床意义。降钙素原是目前临床上一个重要的炎症反应指标，在感染性疾病的诊断中更具有一定的临床意义［1，2］。……