血清PCT、CRP、WBC在脓毒症患者病情及预后评估中的应用价值

张国庆

【摘要】 目的：探討血清PCT、CRP、WBC在脓毒症患者病情及预后评估中的应用价值。方法：选取2018年5月-2020年2月本院收治的脓毒症患者114例为研究对象。根据病情不同分成三组，脓毒症组71例，严重脓毒症组23例，脓毒性休克组20例。比较三组WBC、CRP、PCT水平，比较不同预后患者WBC、CRP、PCT水平，分析血清WBC、CRP与PCT的相关性。结果：三组WBC、CRP、PCT水平比较，差异均有统计学意义（P<0.05）;严重脓毒症组、脓毒性休克组WBC、CRP、PCT水平均高于脓毒症组，脓毒性休克组WBC、CRP、PCT水平均高于严重脓毒症组，差异均有统计学意义（P<0.05）。经过治疗后，有9例死亡，23例无效，82例好转。不同预后患者WBC、CRP、PCT水平比较，差异均有统计学意义（P<0.05）;死亡组WBC、CRP、PCT水平均高于好转组和无效组，无效组WBC、CRP、PCT水平均高于好转组，差异均有统计学意义（P<0.05）。血清WBC、CRP与PCT均呈正相关（P<0.05）。结论：在脓毒症患者病情及预后评估中，通过血清PCT、CRP、WBC可以有效了解患者的身体状况以及病情状态，对于预后评估有一定的价值，临床上应当进一步推广应用。

【关键词】 PCT CRP WBC 脓毒症

[Abstract] Objective： To investigate the application value of serum PCT， CRP and WBC in the evaluation of the condition and prognosis of sepsis patients. Method： A total of 114 patients with sepsis admitted to our hospital from May 2018 to February 2020 were selected as the study subjects. According to different conditions， the patients were divided into three groups， sepsis group of 71 cases， severe sepsis group of 23 cases， septic shock group of 20 cases. The levels of WBC， CRP and PCT in the three groups were compared， the levels of WBC， CRP and PCT in patients with different prognosis were compared， and the correlation between serum WBC， CRP and PCT was analyzed. Result： Comparison of WBC， CRP and PCT levels among the three groups， the differences were statistically significant （P<0.05）. The levels of WBC， CRP and PCT in severe sepsis group and septic shock group were higher than those in sepsis group， the levels of WBC， CRP and PCT in septic shock group were higher than those in severe sepsis group， the differences were statistically significant （P<0.05）. After treatment， 9 cases died， 23 cases were ineffective and 82 cases improved. Comparison of WBC， CRP and PCT levels in patients with different prognosis， the differences were statistically significant （P<0.05）. The levels of WBC， CRP and PCT in the death group were higher than those in the improved group and the invalid group， the levels of WBC， CRP and PCT in the invalid group were higher than those in the improved group， the differences were statistically significant （P<0.05）. Serum WBC， CRP and PCT were positively correlated （P<0.05）. Conclusion： In the evaluation of condition and prognosis of patients with sepsis， serum PCT， CRP and WBC can effectively understand the patient’s physical condition and condition， which is of certain value for prognosis evaluation， and should be further popularized and applied in clinic.

[Key words] PCT CRP WBC Sepsis

First-author’s address： Penglai People’s Hospital， Penglai 265600， China

doi：10.3969/j.issn.1674-4985.2021.25.029

脓毒症是因为感染导致的全身炎症反应综合征，在重症监护病房中，脓毒症属于导致患者死亡的主要因素，此疾病的临床特征为：死亡率高、发生率高、病情复杂等，早期的诊断可以提供治疗依据[1]。一般会通过体液培养和血液培养等检查对脓毒症进行诊断，但是所花费的时间较长，并且和非感染疾病一起诊断时难度增加，缺少特异性[2]。根据相关的研究显示，白细胞计数（white blood cell，WBC）、C反应蛋白（C-reactive protein，CRP）、降钙素原（procalcitonin，PCT）在重症患者病情评估和预后中有指导性作用[3]。本研究探讨的是血清PCT、CRP、WBC在脓毒症患者病情及预后评估中的应用价值，现报道如下。……