摘要
目的研究多发伤患者伤后血清降钙素原(PCT)的水平变化,并探讨其与创伤严重度ISS及危重程度APACHEII评分和脏器功能不全的相关性。方法测定26例多发伤患者伤后24 h内的PCT水平,同时评定ISS、APACHEII分值及脏器功能不全的发生情况和死亡率。在此基础上进行统计分析,了解PCT水平变化及其与脏器功能不全和死亡率的相关性。结果(1)以ISS≤16为分组界限,多发伤患者两组之间PCT值比较,Z=-2.129,P=0.042,差异具有统计学意义。(2)以APACHEII≤20为分组界限,多发伤患者两组之间PCT值比较,Z=-2.117,P=0.034,差异具有统计学意义。(3)以是否发生脏器功能不全为分组标准,两组之间PCT值比较,Z=- 3.089,P=0.002,差异具有统计学意义。(4)以死亡或存活为分组标准,两组之间PCT值比较,Z =-1.307,P=0.191,差异无统计学意义。(5)创伤后24 h内的PCT水平与ISS评分、死亡或存活相关性无统计学意义(P>0.05),与APACHEII评分相关(P=0.033),与OD相关(P= 0.001)。(6)是否发生脏器功能不全,两组之间PCT值比较,差异具有统计学意义(x^2=14.282,P<0.01);当PCT≥10 ng/ml时,脏器功能不全发生率明显增加(x^2=12.831,P<0.01)。结论伤后24 h内的PCT水平与APACHEII、脏器功能不全发生率密切相关,当PCT≥10 ng/ml时,脏器功能不全发生率明显增加。
Objective To study the serum procalcitonin （PCT） in patients with multiple trauma and to determine its relationship with severity of trauma score and organ dysfunction. Method Levels of serum PCT in 26 patients with the multiple trauma at 24 hours after trauma were determined, and the score of ISS and APACHEII were eva; iated. The relation between PCT and ISS, APACHEII and the incidence of organ dysfunction was analyted. Results The level of serum PCT in patients with ISS≤ 16 was lower than those in patients with ISS 〉 16 （ Z = - 2. 129, P - 0.042）, so were between the patients with APACHEII≤ 20 and APACHEII 〉 20 （ Z = -2.117, P =0.034） , and between the patients with OD and without OD （ Z = -3.089, P =0.002）, but PCT was not so between the non-surviror and survivor （ Z = - 1.307, P = 0. 191 ）. The serum PCT level correlated with the incidence of organ dysfunction （72 = 14.82, P = 0.033） and APACHEII （72 = 12.83, P 〈 0.01）. When PCT≥ 10 ng/ml, the incidence of organ dysfunction was higher. Conclusions The PCT correlates with the incidence of organ disfunction and APACHEII. When PCT≥ 10 ng/ml, the probability of organ disfunction is higher.
出处
《中华急诊医学杂志》
CAS
CSCD
2007年第6期572-575,共4页
Chinese Journal of Emergency Medicine
关键词
多发伤
降钙素原
脏器功能不全
Multiple trauma
Procalcitonin （PCT）
Organ disfunction
