| 摘要: |
| 目的探讨血清乳酸和降钙素原（PCT）水平用于各型脓毒症致急性呼吸窘迫综合征（ARDS）预后判断的价值。方法选取脓毒症致ARDS45例、严重脓毒症致ARDS32例、脓毒性休克致ARDS19例共96例患者，在患者入院当天和死亡前分别采用免疫化学发光法和化学分析法检测血清乳酸、PCT水平，统计7d内的病死率。采用ROC曲线评估两种指标对ARDS病情预后的诊断效能。结果血清乳酸和PCT水平以脓毒性休克致ARDS患者最高（P＜0.05），且死亡组患者的水平明显高于生存组，血清乳酸和PCT水平检测用于脓毒症致ARDS预后判断的灵敏度和特异度分别为0.684和0.854，0.895和0.659。结论血清PCT和乳酸对脓毒症致ARDS病情严重程度的判断有一定价值，联合检测可以提高对预后判断的灵敏度和特异度。 |
| 关键词: 急性呼吸窘迫综合征 脓毒症 乳酸 降钙素原 重症医学 |
| DOI：10.12056/j.issn.1006-2785.2017.40.1.2015-1429 |
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| Clinical significance of combination detection for serum lactic acid and procalcitonin levels in acute respiratory distress syndrome(ARDS) caused by sepsis |
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Taizhou First People's Hospital
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| Abstract: |
| Objective To investigate the clinical significance of serum lactic acid and procalcitonin levels in acute
respiratory distress syndrome(ARDS) induced by sepsis. Methods Ninety six patients with ARDS induced by sepsis admitted in intensive care unit (ICU) from March 2013 to October 2015 were recruited. Serum lactic acid and procalcitonin levels were detected with chemical analysis and immune chemiluminescence method, respectively on the day of admission, after disease remission, or before the patients died. And the receiver-operating characteristic curve (ROC curve) was used to assess the diagnostic value of the two markers for ARDS. Results The serum levels of lactic acid and procalcitonin were positively
associated with the severity of ARDS (P＜0.05), the highest level was detected in ARDS induced by septic shock. The sensibility
and specificity of serum lactic acid and procalcitonin were 0.684, 0.854, and 0.895 and 0.659 for assessing disease prognosis, respectively. Conclusion Serum lactic acid and procalcitonin have a certain value in assessing the severity of ARDS caused by sepsis and the sensibility and specificity may be improved by combined detection of two markers. |
| Key words: Acute respiratory distress syndrome Sepsis Lactic acid Procalcitonin Intensive care medicine |
