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肝素结合蛋白联合降钙素原、超敏C反应蛋白对早期脓毒症的诊断及预后评估曾 彬江苏省苏州市立医院本部急诊医学科，江苏苏州 215002[摘要] 目的 探讨肝素结合蛋白（HBP）、降钙素原（PCT）、超敏C反应蛋白（hs-CRP）联合用于诊断早期脓毒症的效果及预后评估。
方法选择2022年7月至2023年6月苏州市立医院收治的早期脓毒症患者72例作为观察组，选择同期住院的非感染疾病患者72例作为对照组，进行回顾性分析，检测HBP、PCT、hs-CRP指标，比较观察组患者与对照组体检者测定结果差异，分别计算单一指标及三项指标联合诊断脓毒症的灵敏度、特异度及准确度。
另外结合观察组患者预后情况比较存活患者与死亡患者三项指标检测结果。
结果观察组脓毒症患者HBP、PCT、hs-CRP水平高于对照组，差异有统计学意义（P < 0.05）。
三项指标联合诊断脓毒症的敏感度、准确度均高于单一指标检测，差异有统计学意义（P < 0.05）。
存活患者HBP、PCT、hs-CRP水平均低于死亡患者，差异有统计学意义（P < 0.05）。
结论 临床诊断早期脓毒症可采用HBP、PCT、hs-CRP三项指标联合分析方式，具有较高的敏感度与准确度，且便于评估患者预后质量，值得推广。
[关键词] 肝素结合蛋白；降钙素原；超敏C反应蛋白；早期脓毒症；预后[中图分类号] R459.7 [文献标识码] A [文章编号] 2095-0616（2024）05-0191-04DOI:10.20116/j.issn2095-0616.2024.05.44Heparin-binding protein combined with procalcitonin and hypersensitive C-reactive protein in the diagnosis and prognosis assessment of early sepsisZENG BinEmergency Medicine Department of Suzhou Municipal Hospital Headquarters, Jiangsu, Suzhou 215002, China [Abstract] Objective To explore the combined use of three indicators of heparin-binding protein (HBP), procalcitonin (PCT), and hypersensitive C-reactive protein (hs-CRP) in the diagnosis and prognosis assessment of early sepsis. Methods A total of 72 patients with early sepsis who were admitted to Suzhou Municipal Hospital for treatment from July 2022 to June 2023 were selected as the observation group, and 72 non-infectious disease patients who were hospitalized in the same hospital during the same period were selected as the control group. A retrospective analysis was conducted, and the indicators of HBP, PCT, and hs-CRP were tested. The differences in the test results between patients in the observation group and physical examiners in the control group were compared, and the sensitivity, specificity, and accuracy of a single indicator and a combination of three indicators for the diagnosis of sepsis were calculated, respectively. In addition, combined with the prognosis of patients in the observation group, the results of the three indicators of survivors and the dead were compared. Results The levels of HBP, PCT, and hs CRP in the observation group of sepsis patients were higher than those in the control group, with statistically significant differences (P< 0.05). The sensitivity and accuracy of the combined diagnosis of sepsis using three indicators are higher than those of single indicator detection, with statistically significant differences (P< 0.05). The levels of HBP, PCT, and hs CRP in surviving patients were lower than those in deceased patients, with statistically significant differences (P< 0.05). Conclusion The analysis of a combination of three indicators of heparin-binding protein, procalcitonin, and high-sensitivity C-reactive protein can be used for clinical diagnosis of early sepsis, which has high sensitivity and accuracy and is convenient for assessing the quality of patient prognosis. Therefore, it is worth promoting.[Key words] Heparin-binding protein; Procalcitonin; Hypersensitive C-reactive protein; Early sepsis; Prognosis脓毒症属于急危重症之一，其以病情发展速度快、症状严重为主要特点，临床病死率相对较高，是各级医院ICU 患者非心脏病变类病死的重要诱因[1]。
脓毒症儿童降钙素原测定的临床评价目的探讨血清降钙素原测定对脓毒症患儿的诊断及预后的临床意义。
方法选取2014年2月～2016年2月本院儿科收治的感染患儿100例，按照脓毒症的诊断标准，分为严重脓毒症组（17例）、非严重脓毒症组（23例）和非脓毒症组（60例），所有患儿于入院24 h内进行血清降钙素原（PCT）、C-反应蛋白（CRP）、白细胞（WBC）计数测定，同时进行小儿危重症评分。
结果非脓毒症组、非严重脓毒症组及严重脓毒血症组的危重评分、PCT、CRP、WBC差异有统计学意义（P＜0.01）；其中严重脓毒症组与非严重脓毒血症组的PCT、CRP、WBC均高于非脓毒症组（P＜0.01），严重脓毒症组的CRP、WBC水平与非严重脓毒症组差异无统计学意义（P>0.05）。
结论在脓毒症诊断中，PCT 优于CRP、WBC，是敏感的血清学指标；PCT水平越高，危重症评分越低。
[Abstract]Objective To explore the clinical sinificance of procalcitonin （PCT）for diagnosis and prognosis of children with sepsis.Methods 100 infected children treated in department of pediatrics in our hospital from February 2014 to February 2016 were selected.They were divided into the severe sepsis group （17 cases），non severe sepsis group （23 cases），and non-sepsis group （60 cases）according to the diagnosis criteria.PCT，CRP，WBC were determined and pediatric critical illness score （PICS）was conducted in all cases within 24 hour after admission.Results There was a satatistical difference in PICS，PCT，CRP，WBC among the three groups （P＜0.01）.The level of PCT，CRP，WBC in the severe sepsis group and non severe sepsis group were higher than those in the non-sepsis group （P＜0.01）.There was no statistical difference of CRP，PCT level between the severe sepsis group and non severe sepsis group （P>0.05）.Conclusion In the diagnosis of sepsis，PCT is better than CRP and WBC，and it is a sensitive serological indicator.The higher the level of PCT，the lower the PICS.[Key words]Sepsis；Children；Procalcitonin膿毒症属于全身炎症反应综合征（SIRS），主要由感染所引起。
