| 摘要: |
| 目的探讨肝素结合蛋白（HBP）、降钙素原（PCT）、C反应蛋白（CRP）、WBC在脓毒症诊断及分级中的临床应用价值。方法选取脓毒症患者22例、重症脓毒症患者25例、脓毒症休克患者20例、局部感染患者21例以及健康体检者29例，测定各组患者血清HBP、PCT、CRP及全血WBC水平，并对部分病例进行HBP与PCT的跟综监测。结果（1）脓毒症组HBP、PCT、CRP水平明显高于局部感染和健康对照组，差异均有统计学意义（均P＜0.05）；脓毒症、重症脓毒症、脓毒性休克组中PCT水平分别为2.3（0.6～5.1）、6.2（2.8～16.1）、15.3（4.4～49.0）ng/ml，各组间差异有统计学意义（P＜0.05）；脓毒症组HBP为283.1（168.9～397.6）ng/ml，高于脓毒性休克组的111.6（62.6～250.5）ng/ml（P＜0.05）。CRP在脓毒症分级中无统计学意义（P＞0.05）。（2）跟综监测显示，在脓毒症的进展过程中，PCT水平进行性升高，而HBP水平却下降。（3）HBP与PCT联合诊断脓毒症的效能高于单一指标的应用。结论在HBP、PCT是脓毒症诊断的有效标志物，HBP和PCT联合检测有助于脓毒症的诊断，PCT进行性升高而HBP下降提示疾病预后不良。 |
| 关键词: 脓毒症 降钙素原 肝素结合蛋白 C 反应蛋白 |
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| Combined detection of heparin-binding protein and procalcitonin in diagnosis and classifications of sepsis |
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CHEN Yongjian, WNAG Yu
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Zhejiang provincial People's Hospital
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| Abstract: |
| Objective To assess the detection of heparin-binding protein (HBP), procalcitonin (PCT), white blood cell (WBC), C-reactive protein (CRP) in diagnosis and classification of sepsis. Methods Sixty seven septic patients, including 22 with sepsis, 25 with severe sepsis and 20 with septic shock, 21 patients with local infection, 29 healthy controls were enrolled in the study. Levels of HBP, PCT, WBC and CRP were determined. Results The levels of HBP, PCT and CRP in the sepsis group were significantly higher than those in local infection group or control group (P＜0.05). The PCT levels in the groups of sepsis, severe sepsis, and septic shock were 2.3(0.6-5.1)ng/ml, 6.2(2.8-16.1)ng/mL and 15.3(4.4-49.0)ng/mL, respectively(P＜0.05), HBP level in sepsis group was higher[283.1(168.9-397.6)ng/mL] than that in septic shock group[111.6(62.6-250.5)ng/mL](P＜ 0.05), however there was no significant difference in CRP levels among 3 sepsis groups (P ＞0.05). The effectiveness of HBP and PCT combination in the diagnosis of sepsis was higher than that of single index. Conclusion HBP and PCT are effective markers for diagnosis and classification of sepsis, the combination of two indexes would increase the diagnostic effectiveness. |
| Key words: Sepsis Procalcitonin Heparin-binding protein CRP |
