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周杨青,黄建平,应卡利,李欣泽.脓毒症患者PCT及D-二聚体与中医证型相关性的临床研究[J].浙江中西医结合杂志,2018,28(9):
脓毒症患者PCT及D-二聚体与中医证型相关性的临床研究
Clinical Research on the correlation between TCM Syndrome and PCT and d-dimer in sepsis patients
投稿时间:2018-01-02  修订日期:2018-06-28
DOI:
中文关键词:  脓毒症 中医证型 血清降钙素原 D-二聚体
英文关键词:Sepsis  TCM Syndrome  PCT  D-dimer
基金项目:浙江省中医药管理局中医药科学研究(2017ZB084)作者单位:1.浙江宁波市北仑区人民医院中医科(浙江宁波 315800);2. 浙江宁波市北仑区人民医院急诊科(浙江宁波 315800)通讯作者:周杨青,Tel:18757408667,E-mail:284740515@qq.com 黄建平2 应卡利1 李欣泽1
作者单位E-mail
周杨青 宁波市北仑区人民医院 284740515@qq.com 
黄建平 宁波市北仑区人民医院急诊科  
应卡利 宁波市北仑区人民医院中医科  
李欣泽 宁波市北仑区人民医院中医科  
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中文摘要:
      目的 探讨血清降钙素原(PCT)及D-二聚体(D-D)的表达与脓毒症中医证型的关系。方法 将496例脓毒症患者按中医辨证分为毒热证、腑气不通证、血瘀证及急性虚证四组,分别测定脓毒症患者PCT及D-D水平,分别进行组间比较,根据结果绘制ROC曲线,并计算相关参数。结果 毒热证患者PCT含量明显高于其他各组,差异有统计学意义(P<0.01),以其余三组证型患者为对照,绘制ROC曲线,AUC面积为0.760,P<0.01,有统计学差异,其最佳临界值为3.66ng/mL,敏感度为78.50%,特异度为66.40%,阳性预测值为57.30%,阴性预测值为84.31%;血瘀证患者D-D水平高于其他各组,差异有统计学意义(P<0.01),以其余三组证型患者为对照,绘制ROC曲线,AUC面积为0.774,P<0.01,有统计学差异,其最佳临界值为1.50mg/L,敏感度为54.50%,特异度为91.20%,阳性预测值为98.27%,阴性预测值为17.95%。结论 PCT及D-D可分别作为脓毒血症之毒热证、血瘀证的客观指标,以3.66ng/mL作为PCT诊断热毒证及1.50mg/L作为D-D诊断血瘀证的临界值较为合适,可提高其临床诊疗效率,对指导临床治疗有重要意义。
英文摘要:
      ObjectiveTo investigate the correlation between the expression of serum calcitonin (PCT) and d-dimer (d-d) and the TCM syndromes of sepsis . Methods:According to TCM syndrome differentiation of 496 cases of sepsis, the patients with sepsis were divided into four groups,which were heat-toxin syndrome ,bowel-qisyndrome,blood stasis syndromeandacu deficiency syndrome , the PCT and d-d levels were respectively measured,and Compare between groups,Draw the ROC curve according to the results and calculate the relative parameters.?Results:Heat-toxin syndrome patients PCT levels are significantly higher than other groups, and with significant difference (P < 0.01), The ROC curve was drawn in comparison with the other three groups of syndromes,and the AUC area is 0.760, P < 0.01, the difference was statistically significant ,The optimum critical value was 3.66 ng/mL, the sensitivity was 78.50%, the specificity was 66.40%, the positive predictive value was 57.30%, and the negative predictive value was 84.31% ; Blood stasis patients with D - D levels higher than the other groups, and with significant difference (P < 0.01), The ROC curve was drawn in comparison with the other three groups of syndromes,and the AUC area is0.774, P < 0.01, the difference was statistically significant ,The optimum critical value was 1.50mg/L, the sensitivity was 54.50%, the specificity was 91.20%, the positive predictive value was 98.27%, and the negative predictive value was 17.95% .Conclusion PCT and D-D can be used as the objective index of the fever and blood stasis syndrome of sepsis,and it is suitable that using 3.66ng/mL as PCT diagnosis of thermotoxic syndrome and 1.5mg/L as the critical value of d-d to diagnose blood stasis syndrome, the clinical diagnosis and treatment efficiency can be improved,as a significant value for directing clinil treatment.
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