摘要
目的探讨血浆中性粒细胞明胶酶相关脂质运载蛋白（neutrophil gelatinase associated lipocalin,NGAL）及血浆降钙素原（Procalcitonin,PCT）的含量及其对多发伤并脓毒症的预测价值。方法回顾性分析2013年1月—2015年1月收治的符合纳入标准的多发伤患者100例,其中男81例,女19例;年龄18-72（40.5±9.5）岁。根据是否出现脓毒症进行分组,记录并比较两组的年龄、性别、体温、心率、血压、呼吸、损伤严重度评分（injury severity score,ISS）、创伤类型、血浆PCT及NGAL水平,并采用多因素Logistic回归分析多发伤并脓毒症的危险因素。结果单因素分析显示创伤类型、入院时血浆NGAL和PCT与多发伤并脓毒症有一定相关性（P〈0.05）。多因素Logistic回归分析显示入院时血浆NGAL的比值比（OR）值为3.427,95%可信区间（CI）为（1.984,5.415）,入院时血浆PCT的OR值为6.247,95%CI为（3.965,9.862）,是脓毒症的独立危险因素。入院时、入院后24 h及48 h时血浆NGAL及PCT脓毒症组均高于非脓毒症组,差异有统计学意义（P〈0.05）。结论血浆NGAL和PCT水平在一定程度上可预测多发伤患者是否合并脓毒症。
Objective To investigate the levels of serum,nentrophil gelatinase associated lipocalin（ NGAL） and procalcitionin（ PCT） in patients following multiple trauma,discuss the relationship between NGAL,PCT and multiple trauma with sepsis,and evaluate the predictive values in multiple trauma with sepsis. Methods A retrospective analysis was performed on 100 multiple trauma patients who met the inclusion criteria and treated during January 2013 and January 2015.There were 81 males and 19 females with an average age of 40. 5 ± 9. 5 years（ range between 18-72 years）. They were divided into two groups according to presence or absence of sepsis. Age,gender,body temperature,heart rate,blood pressure,breathing,ISS（ injury severity score）,injury types,PCT and NGAL upon admission were compared between the two groups.Multi-factor logistic regression analysis was applied to discuss the related risk factors of sepsis in multiple trauma. Results Single factor analysis showed that for injury types,PCT and NGAL upon admission,there was a certain correlation between multiple trauma and sepsis（ P〈0. 05）. Multi-factor logistic regression analysis showed that risk factors for sepsis were NGAL with OR values of 3. 427（ 95% CI： 1. 948,5. 415） and PCT with OR value of 6. 247（ 95% CI： 3. 965,9. 862）. NGAL and PCT of the group with sepsis were higher than that of the group without sepsis upon admission,24 h,and 48 h after treatment with significant difference（ P〈0. 05）. Conclusion NGAL and plasma PCT may be two reliable parameters for early diagnosis of sepsis after trauma.
出处
《临床误诊误治》
2016年第6期81-84,共4页
Clinical Misdiagnosis & Mistherapy
基金
河北省医学科学研究重点课题计划(20150395)
