Crit Care:血清降钙素原在重症患者中的预后价值

2019-12-04 xing.T MedSci原创

由此可见,PCT有望成为创伤的替代生物标志物。最初的PCT峰值水平可以作为脓毒症、MOD和创伤人群死亡率的早期预测指标。

重大创伤与脓毒症并发症和多器官功能障碍(MOD)的发生率高有关,这显著影响受伤患者的预后。尽早发现有创伤后并发症风险的患者对于提供早期治疗和改善预后至关重要。近日,危重病医学领域权威杂志Critical Care上发表了一篇研究文章,研究人员试图评估创伤后血清降钙素原(PCT)水平与损伤严重程度、败血症、器官功能障碍和死亡率之间的相关性。

研究人员检索了PubMed、MEDLINE、EMBASE、Cochrane数据库以及所纳入文献的参考文献。两名研究者独立确定了合格的研究并提取了数据。研究人员纳入了评估了血清PCT水平在预测重症患者损伤严重程度、败血症、器官功能障碍和死亡率方面预后价值的论著。

在2015篇文献中,有19项研究(前瞻性17项;回顾性2项)符合纳入标准。纳入研究的方法学质量中等。所有研究均显示初始PCT水平与伤害严重度评分(ISS)之间有很强的相关性。在16项研究中,有12项表明在创伤后出现败血症的患者中,初始PCT水平显著升高。在9项研究中有7项,PCT水平似乎是MOD的有力预测指标。尽管2项研究未发现PCT水平与死亡率之间的关联,但4项研究表明非幸存者与幸存者相比PCT水平显著提高。1项研究报道PCT≥5ng/mL与死亡率显著增加有关(OR为3.65;95%CI为1.03-12.9;p=0.04)。

由此可见,PCT有望成为创伤的替代生物标志物。最初的PCT峰值水平可以作为脓毒症、MOD和创伤人群死亡率的早期预测指标。 

原始出处:

Aziza N. AlRawahi,et al.The prognostic value of serum procalcitonin measurements in critically injured patients: a systematic review.Critical Care.2019.https://ccforum.biomedcentral.com/articles/10.1186/s13054-019-2669-1

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    2019-12-05 飛歌

    学习了很有用不錯

    0

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    2019-12-04 1209e435m98(暂无昵称)

    学习了,谢谢分享

    0

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    2019-12-04 1478e879m90暂无昵称

    学习了

    0

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