目的 探讨血清降钙素原(PCT)、C反应蛋白(CRP)与急性生理及慢性健康评分标准Ⅱ(APACHE Ⅱ)评分在转诊肺炎合并脓毒症患者诊断中的相关性,以寻找更为简洁、快速判断其病情严重程度的指标。 方法 2009年1月-2010年12月,选取178例转诊肺炎合并脓毒症患者并进行脓毒症分级,对其进行血清PCT和CRP测定,并与APACHE Ⅱ评分及预后进行相关性分析。 结果 严重脓毒症组及脓毒性休克组患者血清PCT、CRP水平与APACHE Ⅱ评分较全身炎症反应综合征组及脓毒症组高(P<0.05);30 d内死亡的患者其血清PCT、CRP水平及APACHEⅡ评分较存活组明显增高(P<0.05);转诊肺炎合并脓毒症患者血清PCT与APACHE Ⅱ评分呈正相关(r=0.683,P=0.023),与血清CRP水平呈较弱的正相关(r=0.272,P=0.037)。 结论 对转院肺炎合并脓毒症患者进行血清PCT和CRP测定,对病情评估具有一定临床价值,特别是PCT可作为对转诊肺炎合并脓毒症患者病情程度判断的重要指标,为早期干预及治疗提供依据,值得临床推广应用。
This article introduces the exploration and establishment of “grass-roots Party building + targeted poverty alleviation” model by the Party Branch of Emergency Department of West China Hospital of Sichuan University, and discusses how to establish the “trinity mode” of management support, personnel training, and on-site guidance under the leading of grass-roots Party building through a series of the branches combined activities, according to the core idea of “strengthening the Party construction, bringing people closer together, and promoting development”. The aim is to form a long-term mechanism of grass-roots Party building and targeted medical poverty alleviation through continuously implementing this model, which can benefit more people in remote and ethnic minority areas and contribute to “Healthy China 2030”.