|
Objective: To investigate pneumonia sepsis patients serum procalcitonin, C-reactive protein in clinical significance. Methods: Inclusion January 2009 to March 2011 were 190 cases admitted to hospital with pneumonia, sepsis group, 72 cases of non-grouping, mild sepsis group 87 cases, 19 cases of severe sepsis, septic shock group of 12 patients in each group were compared between the PCT, hsCRP, APACHE Ⅱ score differences. Condition to improve the situation by improving the group and no improvement is divided into groups, each group were compared before treatment and 4-7 days after the PCT, hsCRP, APACHE Ⅱ score differences. Drawing receiver operating curve (ROC curve), analyzing PCT, hsCRP, APACHE Ⅱ score for pneumonia with sepsis (including mild sepsis, severe sepsis, septic shock), severe sepsis and pneumonia septic shock, pneumonia diagnosis of septic shock. Rank correlation analysis with the PCT, hsCRP and APACHE Ⅱ score, PSI rating, CURB-65 score of relationship. Results: PCT, hsCRP, APACHE Ⅱ score with the severity of sepsis increased, following which the PCT, APACHE Ⅱ score in the non-sepsis, mild sepsis, severe sepsis, septic shock four two two were statistically significant differences between (p lt; 0.05); hsCRP in the non-sepsis and sepsis difference between the groups was statistically significant (p lt; 0.05), each group in sepsis The difference was not statistically significant (p gt; 0.05). Improve the condition of patients after treatment PCT, hsCRP, APACHE Ⅱ score before treatment was significantly lower (P both lt; 0.01); no improvement in patients before and after treatment of the PCT, hsCRP, APACHE Ⅱ score was no significant difference (P all gt; 0.05 ). PCT, hsCRP, APACHE Ⅱ score diagnose pneumonia and sepsis (including mild sepsis, severe sepsis, septic shock) The area under the ROC curve was 0.842,0.819,0.790. PCT, hsCRP, APACHE Ⅱ score respectively ≥ 0.5ng/mL, 45mg / L, ≥ 7 is divided into circles diagnosis pneumonia sepsis (including mild sepsis, severe sepsis, septic shock), Sen respectively was 71.19%, 75.42%, 72.03%, Spe were 95.83%, 72.22%, 70.83%. PCT, hsCRP, APACHE Ⅱ score diagnose pneumonia with severe sepsis and septic shock, the area under the ROC curve was 0.876,0.769,0.887. PCT, hsCRP, APACHE Ⅱ score respectively ≥ 2ng/ml, ≥ 75mg / L, ≥ 11 is divided into circles diagnose pneumonia with severe sepsis and septic shock, Sen were 61.29%, 80.65%, 90.32%, Spe respectively of 88.05%, 67.92%, 81.76%. PCT, hsCRP, APACHE Ⅱ score diagnose pneumonia complicated by septic shock area under the ROC curve was 0.950,0.786,0.946. PCT, hsCRP, APACHE Ⅱ score respectively ≥ 10ng/ml, ≥ 140mg / L, ≥ 15 is divided into circles diagnose pneumonia with septic shock, Sen were 58.33%, 58.33%, 75.00%, Spe were 96.07%, 85.39 %, 90.45%. Correlation analysis showed that PCT, hsCRP and APACHE Ⅱ score, PSI rating, CURB-65 score was significantly positively correlated (r = 0.708,0.676,0.713 the former, the latter r = 0.489,0.414,0.474, p are lt; 0.01). Conclusion: PCT, hsCRP and pneumonia severity positively correlated more severe the disease, the higher the level, PCT relevance than hsCRP; both for judging the severity of pneumonia and sepsis have a certain application value, including sensitive hsCRP better than PCT, and the PCT specificity superior to hsCRP, PCT than hsCRP better reflect the severity of sepsis.
|