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降钙素原与急性生理与慢性健康评分判断腹腔感染脓毒症病原菌类型和患者预后的价值
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R459.7

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The value of procalcitonin and acute physiology and chronic health evaluation in determining pathogenic bacteria type and prognosis of patients with abdominal infection sepsis
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    摘要:

    目的?通过检测降钙素原(PCT)水平和统计急性生理与慢性健康评分(APACHE Ⅱ),分析其判断腹腔感染脓 毒症病原菌类型和患者预后的价值。方法?选取 2017 年 5 月至 2021 年 5 月陕西省人民医院收治的 90 例腹腔感染脓毒症 患者为研究对象,进行回顾性分析。根据 28 d 内不同预后分为死亡组(28 例,患者死亡)和存活组(62 例,患者存活)。 比较两组患者血清 PCT 水平与 APACHE Ⅱ评分。采用受试者工作曲线(ROC)分析 PCT 水平与 APACHE Ⅱ评分对判断 患者病原菌类型和预后的价值。结果?死亡组患者血清 PCT 和 APACHE Ⅱ评分显著高于存活组(P <0.05)。病原菌以 革兰阴性菌(G- 菌)为主,占 66.67%,其中以大肠埃希菌最为常见,占 40.00%。PCT 判断腹腔感染脓毒症患者 G- 菌感 染的AUC 值为 0.790(SE=0.072,95%CI=0.649~0.932,P=0.002),敏感度为 0.643,特异度为 0.903。APACHE Ⅱ评 分判断患者 28 d 病死率的AUC 值为 0.767(SE=0.070,95%CI=0.629~0.904,P=0.004),敏感度为 0.933,特异度为 0.567。 结论?腹腔感染脓毒症患者 PCT 水平和 APACHE Ⅱ评分异常升高,其中 PCT 有助于判断病原菌类型,而 APACHE Ⅱ评 分有助于判断患者短期预后。

    Abstract:

    Objective?By detecting the level of procalcitonin (PCT) and statistical acute physiology and chronic health evaluation score (APACHE Ⅱ ), to study its value in judging the pathogen type and prognosis of patients with abdominal infection sepsis. Methods?A total of 90 patients with abdominal infection and sepsis in Shaanxi Provincial People’s Hospital from May 2017 to May 2021 were selected as the research subjects. According to different outcomes within 28 days, they were divided into death group (28 cases, patients died) and survival group (62 cases, patients survived) for retrospective analysis. The levels of serum PCT and APACHEⅡ were compared between the two groups. The re-ceiver operator characteristic (ROC) were used to analyze the value of PCT and APACHE Ⅱ score in judging the prognosis and pathogen types of patients. Results?The scores of serum PCT and APACHE Ⅱ in the death group were significantly higher than those in the survival group (P <0.05). The main pathogen was G- bacteria in the 90 patients with abdominal infection sepsis, which accounting for 66.67%, of which Escherichia coli was the most common, accounting for 40.00%. The AUC value of Gbacteria in patients with abdominal infection sepsis judged by PCT was 0.790 (SE=0.072, 95%CI=0.649~0.932, P=0.002), the sensitivity was 0.643 and the specificity was 0.903. The AUC value of APACHE Ⅱ to judge the 28 day mortality of patients was 0.767 (SE=0.070, 95%CI=0.629~0.904, P=0.004), the sensitivity was 0.933 and the specificity was 0.567. Conclusion?The PCT and APACHE Ⅱ scores are abnormally elevated in patients with abdominal infection sepsis. PCT is helpful to judge the type of pathogen infection, and APACHE Ⅱ score is helpful to judge the short-term prognosis.

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  • 在线发布日期: 2022-07-21
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