目的: 探讨脓毒血症病人血清降钙素原( PCT) 、血小板( PLT) 计数、C 反应蛋白( CＲP) 、乳酸( LAC) 的水平对判断病人病情严重程度及预后状况的应用价值。方法: 选择 2016－01 ～ 2018－06 期间在我院诊治的 90 例脓毒血症病人( 脓毒血症组) ，并选择同期在我院治疗的非脓毒血症病人 90 例( 对照组) ，检测 2 组病人早期 血清 PCT、PLT 计数、CＲP 及 LAC 的水平，并记录脓毒血症组病人 30 d 内的预后情况。结果: 脓毒血症病人的血 清 PCT、CＲP、LAC 水平均明显高于对照组( P＜0．05) ; 脓毒血症的血清 PLT 计数明显低于对照组( P＜0．05) ，; 脓 毒血症休克病人血清 PCT、CＲP、LAC 水平均明显高于其他两组病人( P＜0．05) ; 血清 PLT 计数明显低于两组病人 ( P＜0．05) ; 脓毒血症病人入院后死亡 28 例，病死率31．11%，死亡组病人的血清 PCT、CＲP、LAC 水平均明显高于 存活组病人( P＜0．05) ; 死亡组病人的 PLT 计数明显低于存活组病人( P＜0．05) 。结论: 联合检测血清 PCT、PLT 计数、CＲP 及 LAC 水平对判断脓毒血症病人病情严重程度及预后状况具有较高的临床价值。

Objective: To investigate the value of serum procalcitonin，platelet，C－reactive protein and lactic acid in judging the severity and prognosis of sepsis． Methods: 90 sepsis patients( sepsis group) and 90 non－sepsis patients( control group) were selected from January 2016 to June 2018．The levels of PCT，PLT，CＲP and LAC in serum of the two groups were detected in the early stage，and the prognosis of the sepsis group within 30 days was recorded．Ｒesults: The serum levels of PCT，CＲP and LAC in sepsis patients were significantly higher than those in control group( P＜0．05) ，the serum PLT count in sepsis patients was significantly lower than that in control group( P＜0．05) ，and the serum lev- els of PCT，CＲP and LAC in sepsis shock patients were significantly higher than those in other two groups( P＜0．05) ．The mortality rate was 31．11%．The levels of PCT，CＲP and LAC in the death group were significantly higher than those in the survival group( P＜0．05) ．The P LT count in the death group was significantly lower than that in the survival group( P＜0．05) ．Conclusion: Combined detection of se- rum PCT，PLT count，CＲP and LAC levels has a high clinical value in judging the severity of sepsis and prognosis．

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收稿日期: 2019－01－23; 修回日期: 2019－05－08 基金项目: 国家自然科学基金资助项目( 81360109，81660267) ; 内蒙自然科学基金资助项目( 2013MS1163 作者简介: 许琳( 1978－) ，女，内蒙古医科大学附属医院检验科检验师。 通讯作者: 孟俊，主任技师，硕士研究生导师，E－mail: nmfrank@ 163．com 内蒙古医科大学附属医院检验科，010050