目的 探讨脓毒症患者的病情预后与高密度脂蛋白（HDL）之间的关联性。 方法 2008年3月1日－2010年2月28日选择50例严重脓毒症患者（脓毒症组）和30例非脓毒症的健康人（对照组），比较两组急性生理学与慢性健康状况评分Ⅱ（APACHEⅡ）和HDL水平。 结果 脓毒症组的HDL水平为（1.10 ± 0.39）mmol/L，对照组HDL水平为（1.61 ± 0.42） mmol/L，两组差异有统计学意义（t=6.786，P=0.000）。多因素非条件logistic回归分析显示，HDL水平（OR=0.877，P=0.025）和APACHEⅡ评分（OR=15.556，P=0.009）是影响脓毒症患者患病程度的两个有效独立因素。 结论 脓毒症能够导致患者的脂代谢出现紊乱，HDL水平是评估脓毒症患病程度的较好指标。
Objective According to characteristics of the wounded, we discussed the key points of Triage Algorithm during the large scale disasters occurring. It will provide some suggestion for establ ishment the triage process, matching with reasonable medical resources on time and making medical care promotion. Method Analysis the data of patients sent to emergency department of West China Hospital in different periods after temblor, and make conclusion on alternation of the triage process. Result A total of 2621 wounded people have been treated in West China Hospital three weeks after earthquake. The severity of patients in a seimic disaster sent to hospital changed as time went on. The percentage of skin and soft tissue injuries and l imbs fractures is 45%. The percentage of crush injury is 4.3%. There are five cases of gas gangrene and none of hospital cross-infection. Conclusion Triage the victims after earthquake dynamically increases the survival rate and decreases the mortal ity and overtriage rate, the key process of triage systems should be modified dynamically with characters alternation of the victims after China Wenchuan earthquake, the rescue level and effect can be made progress.
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。