降钙素原、C反应蛋白与线粒体DNA水平检测在老年脓毒症多器官功能衰竭病情评估中的应用

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摘要目的探讨降钙素原（PCT）、C反应蛋白（CRP）与线粒体DNA（mt-DNA）水平检测在老年脓毒症多器官功能衰竭（MODSE）病情评估中的应用价值。方法选取2014年1月～2016年12月我院收治的62例老年脓毒症患者，将其中合并器官功能衰竭的29例患者设为衰竭组，未合并器官功能衰竭的33例患者设为未衰竭组；选取同期的30例正常体检者作为对照组。比较三组受检者的PCT、CRP、mt-DNA水平差异。结果脓毒症患者的PCT、CRP、mt-DNA水平均显著高于对照组（P＜0.05），衰竭组的mt-DNA、PCT水平显著高于未衰竭组（P＜0.05），但衰竭组的CRP水平与未衰竭组比较，差异无统计学意义（P＞0.05）。根据器官衰竭情况进一步分组，分为单器官衰竭组（11例）、双器官衰竭组（9例）、三个及以上器官衰竭组（9例），随着衰竭器官数量的增多，患者的mt-DNA、PCT水平也显著增高，各组间比较差异均有统计学意义（P＜0.05），但各组间CRP水平比较，差异无统计学意义（P＞0.05）。结论PCT、CRP及mt-DNA均能提示老年患者脓毒症的发生，PCT、mt-DNA水平测定不但能够用于脓毒症的诊断，更能够用于老年脓毒症患者器官功能衰竭情况的评估，值得在临床中推广和应用。

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	廖小龙
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关键词 ：脓毒症, 多器官功能衰竭, 老年, 降钙素原, C反应蛋白, 线粒体DNA

Abstract：ObjectiveTo explore the application values of procalcitonin(PCT),C-reactive protein(CRP)and mitochondrial DNA(mt-DNA)level test in the assessment of multiple organ dysfunction in multiple organ dysfunction in elderly(MODSE)patients with sepsis.MethodsFrom January 2014 to December 2016,62 elderly patients with sepsis admitted into our hospital were selected as research objects.Among them,29 patients complicated with organ failure were classified into the failure group,and the rest was categorized into the non-failure group.Meanwhile,another group of 30 healthy participants after physical examinations was classified into the control group.The differences of PCT,CRP,and mt-DNA levels were compared.ResultsThe levels of PCT,CRP and mt-DNA levels in sepsis patients were significantly higher than those in the control group (P＜0.05).The levels of mt-DNA and PCT in the failure group were significantly higher than those in the non-failure group(P＜0.05).But,there was no great difference in CRP between the failure group and the non-failure group (P＞0.05).According to the conditions of organ failure,the patients were further divided into the single-organ failure group (n=11),the double-organ failure group (n=9),and the three or above organ failure group(n=9).With the increased number of failure organs,the levels of mt-DNA and PCT were greatly increased,which were displayed statistical significance between inter-group comparison(P＜0.05),the CRP level was not in a statistical difference after comparison(P＞0.05).ConclusionProcalcitonin,CRP and mt-DNA all can indicate the occurrence of sepsis in elderly patients.Test of PCT and mt-DNA levels can not only be used in the diagnosis of sepsis,but also to evaluate the MODSE patients with sepsis,which is worthy of clinical promotion and application.

Key words： Sepsis Multiple organ dysfunction Elderly Procalcitonin C-reactive protein Mitochondrial DNA

基金资助:广东省自然科学基金项目（2016A030313814）

作者简介: 廖小龙（1974-），男，广东河源人，博士，主治医师，主要从事脓毒症、多器官功能衰竭、心肌缺血方向的研究

引用本文:

廖小龙;郭伟新;王中华;梁骏;王首红. 降钙素原、C反应蛋白与线粒体DNA水平检测在老年脓毒症多器官功能衰竭病情评估中的应用[J]. 中国当代医药, 2017, 24(30): 123-125.
LIAO Xiao-long;GUO Wei-xin;WANG Zhong-hua;LIANG Jun;WANG Shou-hong. Application of procalcitonin,C-reactive protein and mitochondrial DNA level test in the assessment of multiple organ dysfunction in elderly patients with sepsis. 中国当代医药, 2017, 24(30): 123-125.

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http://dangdaiyiyao.com/CN/ 或 http://dangdaiyiyao.com/CN/Y2017/V24/I30/123

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