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目的比较PCT(前降钙素)水平、APACHEIII评分和MODS评分对SIRS(系统性炎症反应综合征)患者预后的预测能力。方法将1998年11月～2004年11月间入住我院ICU,满足SIRS标准的95例患者纳入此次研究。PCT在动脉血样本中检测,记录患者入院第1个24h后APACHEIII和MODS评分,连续2周每天记录1次或直到患者出院或死亡。将患者按预后分成两组,生存者(n=71)和非生存者(n=24)。按照PCT水平的变化结果又分为3组下降组、升高组、无变化组。结果在整个研究期间APACHEIII和MODS评分在生存者和非生存者之间都有显著区别,但是PCT在生存者和非生存者之间区别仅表现在第1到第7天,入院当天按PCT的水平所分的三组中生存者和非生存者PCT的值无显著性区别。PCT、APACHEIII评分和MODS评分第1天预测死亡率的ROC曲线下面积分别为0.690,0.915,0.913。结论PCT可以作为SIRS患者死亡率的预测因子,但是可靠性低于APACHEIII和MODS评分。
Objective To compare the predictive ability of PCT (procalcitonin) level, APACHEIII score and MODS score in prognosis of patients with SIRS (systemic inflammatory response syndrome). Methods From November 1998 to November 2004 admitted to our hospital ICU, to meet the SIRS standard 95 patients included in this study. PCT was detected in arterial blood samples, and APACHEIII and MODS scores were recorded on the first 24h after admission. Patients were recorded once a day for two weeks or until patients were discharged or died. Patients were divided into two groups according to prognosis, survivors (n = 71) and non-survivors (n = 24). PCT changes in accordance with the level of the results are further divided into three groups decreased group, elevated group, no change group. Results APACHEIII and MODS scores were significantly different between survivors and non-survivors throughout the study, but PCT differed only between days 1 and 7 on survivors and non-survivors, on the day of admission as PCT There was no significant difference in PCT values between survivors and non-survivors in the three groups. The area under the ROC curve for predicted mortality at day 1 for the PCT, APACHEIII, and MODS scores was 0.690, 0.915, 0.913, respectively. Conclusions PCT can be used as a predictor of mortality in patients with SIRS but with less reliability than APACHEIII and MODS scores.