多发伤患者血清降钙素原的变化  

Changes of serum procalcitonin in multiple trauma patients

作　　者：费军[1] 余洪俊[2] 周健[1] 黄显凯[1] 梁华平[3] 蒋耀光[1] 

机构地区：[1]第三军医大学附属大坪医院野战外科研究所创伤科,重庆400040 [2]第三军医大学附属西南医院康复理疗科 [3]第三军医大学附属大坪医院野战外科研究所创伤,烧伤与复合伤国家重点实验室第一研究室,重庆400040

出　　处：《中华创伤杂志》2005年第10期725-728,共4页Chinese Journal of Trauma

摘　　要：目的研究多发伤患者血清降钙素原的变化,并探讨其与损伤严重度、感染及多器官功能障碍综合征(MODS)的关系。方法测定33例多发伤患者伤后第1天、第3天、第7天血清降钙素原水平,同时评定损伤严重度评分(ISS)值、急性病生理学和长期健康评价(APACHE)Ⅱ计分及记录血常规、血糖、感染、MODS情况。结果伤后24h,3,7d多发伤患者血清降钙素原水平显著高于正常对照组(P<0.01),伤后24h内降钙素原水平与APACHEⅡ计分呈正相关(rs=0.601,P<0.05),发生MODS组降钙素原、白细胞计数、血糖及APACHEⅡ值均明显高于脏器功能正常组(P<0.05);发生感染前后,降钙素原差异有统计学意义(P<0.01)。结论多发伤可引起降钙素原升高,且与损伤严重程度和中性粒细胞、血糖相关;检测降钙素原变化有助于及早发现感染,并可预警MODS的发生。Objective To study the changes of serum procalcitonin in multiple trauma patients and determine their relationship with trauma severity, infection and multiple organ dysfunction syndrome （MODS）. Methods The levels of serum procalcitonin, the values of injury severity score （ISS） , score of acute pathologic and chronic health evaluation Ⅱ （ APACHE Ⅱ ） , blood routine, blood sugar, infection and MODS were determined at days 1, 3 and 7 respectively after trauma in 33 multiple trauma patients. Results The level of serum procalcitonin in multiple trauma patients was much higher than that of normal controls （P 〈0.01 = within 24 hours after injury and positively correlated with APACHE II. In cases with MODS, level of serum procalcitonin, white cells, blood sugar and score of APACHE Ⅱ were all much higher than those of patietns with normal organ function （ P 〈 0.05 ）. Conclusions Multiple trauma may induce increase of serum procalcitonin in trauma patients and positively correlate with trauma severity, neutrophils and blood sugar. Dynamic detection of procalcitonin is helpful for early discovering clinical infection and can warn occurrence of MODS.

关 键 词：降钙素 多处创伤 损伤严重度评分 急性病生理学和长期健康评价 多器官功能不全综合征 血清降钙素原 多发伤 伤患者 APACHEⅡ计分 多器官功能障碍综合征 

分 类 号：R641[医药卫生—外科学]