标题：PCT、LCR及Lac对脓毒症患者病情严重程度及预后的评估价值

      作者：刘建军，吴佳    上海市静安区市北医院重症监护室，上海 200040

      卷次： 2021年32卷13期

      【摘要】 目的 探讨降钙素原(PCT)、乳酸清除率(LCR)及血乳酸(Lac)在脓毒症患者病情严重程度和预后中的评估价值。方法 选取2019年9月至2020年9月因脓毒症在上海市静安区市北医院重症医学科接受治疗的72例患者，于入科时、次日及第3天抽取空腹静脉血和动脉血，测定PCT、Lac水平，并计算24 h LCR，按照患者转归情况将其分为生存组(n=48)和死亡组(n=24)，比较两组患者入科时、次日及3 d后的PCT、Lac水平，治疗结束后计算并比较两组患者的24 h内急性生理学与慢性健康状况评分Ⅱ(APACHEⅡ)及序贯器官衰竭评分(SOFA)；根据24 h LCR水平将患者分为高LCR组(n=39)和低LCR组(n=33)，比较两组患者的初始Lac水平和不良反应发生情况。结果 生存组与死亡组患者入科时的PCT比较差异无统计学意义(P>0.05)，入科次日PCT水平[(29.45±7.01) μg/L vs (33.89±8.11) μg/L]、3 d时PCT水平[(19.45±4.55) μg/L vs (39.76±8.76) μg/L]比较，生存组明显低于死亡组，差异均有统计学意义(P<0.05)；生存组与死亡组患者入科时Lac [(2.98±0.54) mmol/L vs (3.83±0.83) mmol/L]、入科次日Lac [(2.15±0.42) mmol/L vs(3.25±0.67) mmol/L]、3 d时Lac [(1.76±0.24) mmol/L vs (2.75±0.52) mmol/L]比较，生存组明显低于死亡组，差异均有统计学意义(P<0.05)；生存组与死亡组患者APACHEⅡ评分比较差异无统计学意义(P>0.05)，高LCR组和低LCR组患者入科时的PCT、Lac水平比较差异亦无统计学意义(P>0.05)；高LCR组患者的APACHEⅡ、SOFA评分及病死率明显低于低LCR组，差异均具有统计学意义(P<0.05)。结论 PCT、Lac及LCR水平对评估脓毒症患者病情严重程度具有重要参考价值，其变化水平可用于预测患者预后。
      【关键词】 脓毒症；血乳酸；乳酸清除率；降钙素原；预后
      【中图分类号】 R631 【文献标识码】 A 【文章编号】 1003—6350（2021）13—1722—03

Evaluation value of PCT, LCR, and Lac levels on the severity and prognosis of patients with sepsis.
LIU Jian-jun,WU Jia. Department of Intensive Care Medicine, Jing'an District Shibei Hospital of Shanghai, Shanghai 200040, CHINA
【Abstract】 Objective To explore the evaluation value of procalcitonin (PCT), lactate clearance rate (LCR),and blood lactate (Lac) on the severity and prognosis of patients with sepsis. Methods A total of 72 patients were se-lected in this study, who were treated for sepsis in the Department of Intensive Care Medicine at Jing'an District ShibeiHospital of Shanghai from September 2019 to September 2020. Fasting venous blood and arterial blood were drawn atthe time of admission, the next day and the third day after admission to measure the PCT and Lac levels and LCR at 24 h.According to the outcome of patients, they were divided into survival group (n=48) and death group (n=24). The levelsof PCT and Lac at the time of admission, the next day and the third day after admission were compared between the twogroups. After treatment, the score of Acute Physiology and Chronic Health Evaluation (APACHEⅡ) and Sequential Or-gan Failure Assessment (SOFA) within 24 hours were calculated and compared between the two groups. According tothe 24 h LCR levels, the patients were divided into high LCR group (n=39) and low LCR group (n=33), and the initialLac levels and adverse reactions of the two groups were compared. Results There was no statistically significant differ-·短篇论著·doi:10.3969/j.issn.1003-6350.2021.13.026