Abstract：Objective: To analyze the diagnostic value of serum C-reactive protein (CRP), procalcitonin (PCT) and injury severity score (ISS) in patients with severe multiple trauma and abdominal injury, and the prediction of death of patients with organ injury. Methods: The clinical data of 93 patients with severe multiple trauma with abdominal injury in our hospital from August 2017 to January 2020 were retrospectively analyzed. According to the presence or absence of organ injury, the patients were divided into group A (48 cases without organ injury) and group B (45 cases with organ injury). The serum CRP, PCT levels and ISS score were analyzed, and the receiver operating characteristic curve (ROC) was used to analyze the diagnostic value of CRP, PCT and ISS scores in organ injury and to predict death of patients with organ injury. Results: Comparison of PCT, CRP and ISS scores between groups A and B showed statistically significant differences (P<0.05). According to the ROC analysis results, the AUC of PCT, CRP and ISS scores for predicting the death of organ injuries were 0.743, 0.808, and 0.800 respectively; according to the best cut-off value: PCT has a sensitivity of 55.6% and specificity is 97.7%; CRP has a sensitivity of 71.1% and specificity of 83.3%; ISS points have a sensitivity of 60.0% and specificity of 89.6%. In group B, 15 patients with organ injury survived and 30 died. The PCT, CRP and ISS scores of the two types of patients were compared, and the difference was statistically significant (P<0.05). According to the ROC analysis results, the AUC of PCT, CRP and ISS scores for predicting the death of organ injuries were 0.977, 0.976, and 0.960, respectively. According to the best cut-off value: PCT has a sensitivity of 97.0% and a specificity of 86.7%; CRP has a sensitivity of 96.7 and specificity of 86.7%; ISS points have a sensitivity of 98.2% and specificity of 80.0%. Conclusion: If there is organ damage in patients with severe multiple injury and abdominal injury, their PCT, CRP levels and ISS score will be significantly increased, and have certain value in the diagnosis of organ damage, but PCT, CRP levels and ISS have higher value in predicting patients' death.
马武剑, 李玉翠. 严重多发伤伴腹部损伤病人血清CRP PCT水平及损伤严重程度评分ISS对脏器损伤的预测价值[J]. 河北医学, 2021, 27(2): 288-292.
MA Wujian, LI Yucui. Predictive Value of Serum CRP PCT Levels and ISS in Severe Multiple Trauma Patients with Abdominal Injury. HeBei Med, 2021, 27(2): 288-292.
[1] 向庆勇,黎明,文家智.限制性与积极性液体复苏对伴多发伤的中重型颅脑损伤患者凝血功能和预后的影响[J].西部医学,2019,31(6):894~899. [2] Naumann D N,Hazeldine J,Davies D J,et al. Endotheliopathy of trauma is an on-scene phenomenon,and is associated with multiple organ dysfunction syndrome:a prospective observational study[J]. Shock,2018,49(4):1~8. [3] 王鹏,吴喆,雷志刚.外周血TGF-β1与多发伤患者伤情严重程度及并发症的相关性分析[J].空军医学杂志,2018,34(6):387~390. [4] Okabe,Yasuyuki. Risk factors for prolonged mechanical ventilation in patients with severe multiple injuries and blunt chest trauma:a single center retrospective case-control study[J]. Acute Medicine & Surgery,2018,5(2):166~172. [5] 刘士会,吕良峰,胡成文.严重腹部创伤后短期死亡原因调查及危险因素的回顾性分析[J].河北医学,2020,26(2):307~311. [6] Waheed K B,Baig A A,Raza A,et al. Diagnostic accuracy of focused assessment with sonography for trauma for blunt abdominal trauma in the eastern region of saudi arabia[J]. Saudi Medical Journal,2018,39(6):598~602. [7] 胡守芹,丁关保.急诊医师应用创伤超声重点评估法对腹部严重多发伤患者的评估价值[J].中国急救医学,2019,39(5):442~445. [8] 江亚.右美托咪定早期目标镇静在多发伤机械通气中的镇静镇痛效果研究[J].中国全科医学,2019,22(1):95~97. [9] 林晓光,沈楚龙,刘永裕,等.益气扶正、祛瘀解毒法治疗骨科多发伤伴脓毒症的临床观察[J].中国中医急症,2018,27(6):1042~1044. [10] 石玉娜,周晓燕,孙滢,等.血清降钙素原对多发伤合并感染患者病情变化及预后的临床研究[J].中国实验诊断学,2018,22(5):819~822. [11] 黄祺,孙宇,罗莉,等.ICU创伤患者并发脓毒症预警评分系统的建立[J].中华危重病急救医学,2019,31(4):422~427.
2021, Vol. 27 
冀公网安备13080202000677号