降钙素原与单纯脑外伤患者病情严重程度和并发症以及预后的关系  

Correlation of procalcitonin to the severity of injury, complications and outcome of simple brain traunm patients

作　　者：邓水香[1] 曹同瓦[1] 祝禾辰[1] 王昆仑[1] 方勇[1] 

机构地区：[1]复旦大学附属华山医院重症医学科,上海200040

出　　处：《中华急诊医学杂志》2012年第9期1032-1036,共5页Chinese Journal of Emergency Medicine

摘　　要：目的探讨血清降钙素原（PCT）与单纯脑外伤患者病情严重程度、并发症以及预后的关系。方法采用前瞻性观察研究，入选120例单纯性脑外伤患者。分别于患者入院后第1、2、3、5、7、10天早上采集血标本检测血降钙素原和C反应蛋白（CRP）水平，收集患者入院10d内的临床资料并随访患者28d后的生存情况。另选30例健康人群（正常组）作为对照。结果轻、重度脑外伤患者各时段血PCT水平比较差异均具有统计学意义（P〈0．05）。感染组与非感染组PCT水平第1、2天比较，差异无统计学意义，但第3、5、7、10天比较差异具有统计学意义（P〈0．05）。Kaplan-Meier生存分析显示入院高PCT水平组与低PCT水平组患者28d生存率差异具有统计学意义（P〈0．05）。结论入院高PCT水平的患者病情更严重且更容易出现各种并发症包括感染且预后不良。动态监测血PCT水平可以作为判断单纯脑外伤患者病情、感染控制及预后的有效指标之一。Objective To study the changes of serum procalcitonin （PCT） in the patients with simple brain trauma and its relationships with injury of severity, complications and outcome of injury. Methods A total of 120 patients with simple brain trauma were evaluated in a prospective observational study. The serum levels of procalcitonin and C-reactive protein were measured 1, 2, 3, 5, 7 and 10 days after the admission. During the following ten days after admission, the clinical data of patients with simple brain trauma were recorded, and also the patients with 28-day survival were followed up. Another 30 healthy subjects were enrolled in normal group for comparison. Results In different periods after trauma, the PCT levels in brain injury patients with different degree of injury severity were significantly different （ P 〈 0.05 ）. During the first two days after admission, there were no significant differences in serum PCT levels between non-infection group and infection group, but significant differences were found between two groups on the 3rd, 5th, 7th and 10th days （ P 〈 0.05 ）. Kaplan-Meier survival analysis showed the 28 days survival between the group with high PCT level and the group with lower PCT level was statistically significant （ P 〈 0. 05 ）. Conclusions Poor outcomes and complications such as infection were often occurred in simple brain trauma patients with initially high PCT. The frequent determination of serum PCT levels is a useful approach to the judgment of injury severity and prognosis in patients with simple brain trauma.

关 键 词：降钙素原 颅脑外伤 感染 预后 

分 类 号：R651.1[医药卫生—外科学]