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目的:探讨动态监测ICU重症肺炎患者血浆降钙素原(PCT)水平对判断病情严重程度及预后的意义。方法:对55例入ICU的重症肺炎患者在第1、3、7、10天抽取静脉血标本,采用免疫荧光法检测PCT水平,同时监测C反应蛋白(CRP)与白细胞计数(WBC)水平,监测氧合指数(PO2/FIO2),并进行APACHEⅡ及临床肺部感染评分(CPIS)评分,观察患者预后情况。结果:本组病死13例,治愈42例。病死组在治疗后第3、7天PCT水平、APACHEⅡ评分、CPIS评分明显高于治愈组,差异有统计学意义(P<0.05)。结论:重症肺炎患者血浆PCT水平与疾病严重程度显著相关,优于目前临床上使用的WBC、CRP炎症反应参数,动态监测PCT水平变化有助于重症肺炎患者预后的判断。
Objective: To investigate the significance of dynamic monitoring of plasma procalcitonin (PCT) levels in patients with severe pneumonia in ICU to determine the severity and prognosis of ICU. Methods: Venous blood samples were collected on the 1st, 3rd, 7th and 10th day in 55 patients with severe pneumonia admitted to the ICU. The PCT level was detected by immunofluorescence, and the levels of C - reactive protein (CRP) and white blood cell count (WBC) The oxygenation index (PO2 / FIO2) was monitored. APACHE Ⅱ and CPIS scores were also observed. The prognosis of the patients was observed. Results: The group died of 13 cases, 42 cases were cured. The PCT level, APACHEⅡscore and CPIS score of the dead group were significantly higher than those of the cured group on the 3rd and 7th day after treatment (P <0.05). CONCLUSIONS: The plasma PCT level in patients with severe pneumonia is significantly related to the severity of the disease. It is superior to the clinical parameters of WBC and CRP in clinical use. The dynamic monitoring of changes in PCT levels is helpful for the prognosis of patients with severe pneumonia.