实用医学杂志 ›› 2021, Vol. 37 ›› Issue (7): 899-902.doi: 10.3969/j.issn.1006⁃5725.2021.07.014

• 临床研究 • 上一篇    下一篇

血钙水平联合降钙素原清除率对ICU 脓毒症休克患者短期预后的价值

孙才智, 魏晶晶, 朱进, 张铮   

  1. 南京医科大学附属南京医院(南京市第一医院)急诊科(南京 210006)

  • 出版日期:2021-04-10 发布日期:2021-04-10
  • 通讯作者: 张铮 E⁃mail:zz18351891108@126.com
  • 基金资助:

    南京市医学科技发展计划项目(编号:YKK18102); 南京医科大学科技发展基金面上项目(编号:2017NJMU133)

Predictive value of serum calcium combined with procalcitonin clearance in the short⁃term prognosis of pa⁃ tients with septic shock in ICU

SUN Caizhi,WEI Jingjing,ZHU Jin,ZHANG Zheng   

  1. Department of Emergen⁃ cy,Nanjing Hospital Affiliated to Nanjing Medical University,Nanjing 210006,China

  • Online:2021-04-10 Published:2021-04-10
  • Contact: ZHANG Zheng E⁃mail:zz18351891108@126.com

摘要:

目的 探讨血钙联合降钙素原清除率(procalcitonin dearance,PCTc)与脓毒症休克患者短期预后的关系。方法 收集我院 ICU 脓毒症休克患者一般临床资料,记录 APACHEⅡ评分、入住 ICU 时的降钙素原(PCT0 h)及血钙、治疗 24 h 的降钙素原(PCT24 h),计算 24 h PCTc,根据 ICU 住院期间预后分为存活组和死亡组,ROC 曲线分析上述指标对脓毒症休克患者预后的预测效能。结果 与存活组相比,死亡组 患者 PCT 24 h 水平显著升高(P < 0.05),入院时血钙及 24 h PCTc 均明显下降(P < 0.05)。血钙、PCTc 血钙联合 PCTc APACHEⅡ呈负相关,以血钙联合 PCTc 相关性最强(P < 0.05)。ROC 曲线显示血钙联合 PCTc 对脓毒症休克患者预后的预测价值最大。结论 血钙、PCTc 是评估脓毒症休克患者 ICU 住院期间的 病死率的有效预测指标,两者联合应用具有更高的评估价值。

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Abstract:

Objective To investigate the predictive value of serum calcium combined with PCTc in the short⁃term prognosis of septic shock patients. Methods The patients of septic shock admitted to ICU were enrolled. The APACHE Ⅱ scores within 24 hours was collected after admission,the serum calcium and PCT0 h were collected at the time of admission. In addition,procalcitonin was collected 24 h after treatment(PCT24 h)and the 24 h PCTc was calculated. The patients were divided into survival group and death group according to the prognosis during ICU hospitalization. ROC curve was drawn to analyze the diagnostic efficacy of the above indicators for the short ⁃ term prognosis of septic shock patients. Results Compared to the survival group,PCT24 h was significantly higher in the death group(P < 0.05),the serum calcium and PCTc were lower in the death group(P < 0.05). The level of serum calcium,PCTc and serum calcium combined with PCTc were significantly negatively correlated with the APACHEⅡ score,with the strongest correlation of serum calcium combined with PCTc(P < 0.05). ROC curve analysis showed that the diagnostic value of serum calcium combined with PCTc was the largest. Conclusion Serum calcium and PCTc are effective prognostic indicator of ICU mortality during hospitalization for septic shock patients,and the combination of them has the higher evaluation value.

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