【摘要】 目的探讨重症中暑患者血清降钙素原(procalcitonin,PCT)的变化及其临床意义。方法2011年7月-2017年9月上海市嘉定区南翔医院急诊科收治重症中暑患者95例,按病情轻重分为热痉挛组33例,热衰竭组31例,热射病组31例,随机选取同期非中暑住院患者32例作为对照组。比较各组患者入院第1、3、5天血清PCT水平和急性生理功能和慢性健康状况评分系统Ⅱ(acute physiological function and chronic health status scoring systemⅡ,APACHEⅡ)评分。结果3组重症中暑患者在入院第1、3、5天血清PCT水平均较非中暑组升高,差异均有统计学意义(P<0.01);3组重症中暑患者入院第1、3、5天血清PCT水平相互比较差异均有统计学意义(P<0.01),其中热射病组、热衰竭组血清PCT水平高于热痉挛组(P<0.01),热射病组血清PCT水平高于热衰竭组(P<0.01)。3组重症中暑患者入院第1、3、5天APACHEⅡ评分均较非中暑组升高,差异均有统计学意义(P<0.01);3组重症中暑患者入院第1、3、5天APACHEⅡ评分相互比较差异均有统计学意义(P<0.01);热射病组、热衰竭组APACHEⅡ评分高于热痉挛组(P<0.01),热射病组APACHEⅡ评分高于热衰竭组(P<0.01)。重症中暑患者血清PCT水平与APACHEⅡ评分呈正相关关系(r=0.82,P<0.01)。结论重症中暑患者血清PCT水平随病情加重而明显升高,同时APACHEⅡ评分也相应升高。血清PCT水平可以预测重症中暑患者病情严重程度。更多还原

【Abstract】 Objective To explore the changes and clin ical significance of serum procalcitonin(PCT)in patients with severe heat-related illness.Methods Collected from July 2011 to September 2017 Shanghai city jiading district nanxiang hospital emergency department treated 95 cases of severe heat-related illness patients,according to the illness severe state,divided into heat cramps group 33 cases,heat exhaustion group 31 cases and heat stroke group31 selected 32 cases of no heat-related illness inpatients as control group.The levels of serum procalcitonin(PCT)and acute physiological function and chronic health status scoring system II(APACHE II)were compared in the patients of each group in the first,third and fifth days.Results The serum PCT levels of the three groups of severe heat-related illness patients were higher than those of the no heat-related illness group in 1 day,3 days and 5 days after treetment,and the differences were statistically significant(P<0.01).There were statistically significant differences in serum PCT levels between the three groups of patients with severe heat-related illness in 1 day,3 days and 5 days after treetment(P<0.01).The serum PCT levels of the heat stroke group were higher than those in the heat exhaustion group(P<0.01),and the serum PCT levels of heat exhaustion group were higher than those in the heat cramps group(P<0.01).The scores of APACHE Ⅱ of the three groups of severe heat-related illness patients were higher than those of the no heat-related illness group in 1 day,3 days and 5 days after treetment,The differences were statistically significant(P<0.01).There were statistically significant differences between the three groups of patients with severe heat-related illness group in 1 day,3 days and 5 days after treetment(P<0.01).APACHE II scores of the heat stroke group were higher than those in the heat exhaustion group(P<0.01),and APACHE Ⅱ scores of heat exhaustion group were higher than those in the heat cramps group(P<0.01).The serum PCT levels of patients with severe heat-related illness were moderately positively correlated with APACHE Ⅱ scores(r = 0.82,P<0.01).Conclusion The serum PCT levels of patients with severe heat-related illness increased significantly with the severity of the disease,and APACHE II scores also increased.The level of serum PCT can be predict the severity of severe heat-related illness patients.更多还原