C反应蛋白及降钙素原对脓毒血症休克短期预后的预测价值

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Abstract Objective To investigate the value of C-reactive protein and procalcitonin to predict short-term prognosis in pyemia shock patients. Methods A total of 121 patients with pyemia shock hospitalized in the Department of Critical Care Medicine, Guangdong Hospital of Integrated Traditional Chinese and Western Medicine from January 2015 to January 2020 were selected as the study subjects. According to the prognosis within 28 days, they were divided into survival group (83 cases) and death group (38 cases). Sepsis-related organ failure assessment (SOFA), acute physiology and chronic health evaluationⅡ(APACHEⅡ) scores, and related laboratory indicators were collected and compared between the two groups at admission. Cox regression model was used to analyze the influencing factors of death within 28 days. All subjects were divided into low CRP group (≤89.4 mg/L, 42 cases) and high CRP group (＞89.4 mg/L, 79 cases) according to CRP level, and then divided into low PCT group (≤10.0 ng/ml, 97 cases) and high PCT group (＞10.0 ng/ml, 24 cases) according to PCT level. Receiver operating characteristic (ROC) curve was used to analyze the predictive value of CRT and PCT in the short-term prognosis of pyemia shock within 28 days. Kaplan-Meier method was used to analyze 28 d survival curve of patients with different levels of CRP and PCT pyemia shock. Results SOFA and APACHEⅡscores, CRP, PCT, serum creatinine, total bilirubin, and fasting blood glucose in the survival group were lower than those in the death group, while oxygenation index, platelet count, mean arterial pressure in the survival group were higher than those in the death group, with statistical significance (P ＜ 0.05). High SOFA score, high CRP level, and high PCT level were independent risk factors for death within 28 d in pyemia shock patients (HR ＞ 1, P ＜ 0.05), and high oxygenation index was a protective factor (HR ＜ 1, P ＜ 0.05). The area under ROC curve of CRT combined with PCT in the diagnosis of sepsis shock within 28 days was higher than that of CRT and PCT, and the difference was statistically significant (P ＜ 0.05). The 28-day cumulative survival rate of high CRP group was lower than that of low CRP group, and the 28-day cumulative survival rate of high PCT group was lower than that of low PCT group (P ＜ 0.05). Conclusion CRP and PCT are independent risk factors for death within 28 days in patients with pyemia shock, and the combination of CRP and PCT has certain predictive value for the prognosis within 28 days of pyemia shock.

Key words： C-reactive protein Procalcitonin Pyemia shock Short-term prognosis

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	LI Fenghui1 PENG Zhiyun1 TANG Zhongxiang1 XIE Weining2

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LI Fenghui1 PENG Zhiyun1 TANG Zhongxiang1 XIE Weining2. Predictive value of C-reactive protein and procalcitonin in the short-term prognosis of pyemia shock[J]. 中国医药导报, 2021, 18(25): 93-97.

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https://www.yiyaodaobao.com.cn/EN/ OR https://www.yiyaodaobao.com.cn/EN/Y2021/V18/I25/93

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