血清降钙素原对老年胆石症患者术后并发感染的诊断价值  

Diagnostic Value of Serum Procalcitonin Levels in Elderly Patients with Cholelithiasis Complicated by Infection after Biliary Tract Surgery

作　　者：杨至宜 胡塔[1] 

机构地区：[1]广州军区广州总医院检验科,广东广州510010

出　　处：《华南国防医学杂志》2012年第4期339-341,共3页Military Medical Journal of South China

摘　　要：目的探讨血清降钙素原(procalcitonin,PCT)对老年胆石症患者术后并发感染的诊断价值。方法选取老年胆石症术后继发感染的患者41例(感染组),术后未继发感染的患者50例(未感染组),健康体检者20例(对照组);观察三组血清PCT、白细胞计数(white blood cell count,WBC)及C-反应蛋白(C-reactive protein,CRP)水平。动态检测5例术后并发严重感染患者的血清PCT水平,观察其与预后的关系。结果术后24 h,感染组PCT水平明显高于未感染组和对照组(均P<0.001),而未感染组和对照组之间PCT水平无统计学差异(P>0.05);感染组CRP水平与未感染组之间无统计学差异(P>0.05),但都明显高于对照组(均P<0.001);未感染组与对照组之间WBC水平无统计学差异(P>0.05),但都明显低于感染组(均P<0.01)。术后并发重症感染的5例患者中,3例患者的血清PCT值持续在较高水平(均大于13.8 ng/ml),最终抗生素治疗无效死亡;另2例患者PCT水平随着临床症状改善呈下降趋势。结论血清PCT水平对诊断老年胆石症患者术后是否继发感染有重要价值,可作为判断其预后的参考指标。Objective To explore the diagnostic value of serum procalcionin（PCT） levels in elderly patients with cholelithiasis complicated by infection after biliary tract surgery.Methods A total of 41 elderly patients with cholelithiasis complicated by infection after biliary tract surgery were infection group,50 non-infected patients with cholelithiasis were non-infection group,and 20 healthy volunteers were control group.Serum PCT,C-reactive protein（CRP） and white blood cell count（WBC） were tested.The PCT level of 5 severely infected cases were detected dynamically to observed its relation with prognosis.Results At 1 day after surgery,serum PCT level in the infection group was significantly higher than that in the non-infection group and the control group（P0.001）,and there was no statistical difference between the latter two groups（P〉0.05）.CRP levels in the infection group and the non-infection group were not significantly different（P〉0.05）,but higher than that in the control group（P0.001）.WBC in the control group and the non-infection group was not significantly different（P〉0.05）,but lower than that in the infection group（P〈0.001）.In 5 severe infected patients,3 were dead with serum PCT levels always higher than 13.8 ng/ml.PCT levels in the other 2 patients were decreased along with the improvement of clinical symptoms.Conclusion The serum PCT level has critical values for the diagnosis of complicated infection after biliary tract surgery for elderly patients with cholelithiasis and can be utilized as a prognosis predictors.

关 键 词：老年胆石症 降钙素原 C-反应蛋白 

分 类 号：R575.62[医药卫生—消化系统]