降钙素原预测和诊断严重创伤后合并感染的价值  

Value of procalcitonin in predicating and diagnosing the concurrent infection after severe trauma

作　　者：徐巧莲[1] 穆心苇[1] 陈永铭[1] 袁受涛[1] 王翔[1] 

机构地区：[1]南京医科大学附属南京医院重症医学科,江苏南京210006

出　　处：《现代医药卫生》2013年第23期3540-3541,3543,共3页Journal of Modern Medicine & Health

摘　　要：目的比较降钙素原（PCT）和C．反应蛋白（CRP）对严重创伤合并感染的早期诊断及预测价值。方法以2012年1-12月入住南京医科大学附属南京医院重症监护病房（ICU）的外科创伤患者为研究对象，收集其入住ICU后每天的PCT、CRP检测情况。根据美国胸科医师学会标准定义脓毒症、严重脓毒症和脓毒症休克。结果合并感染的创伤患者感染前1天及诊断感染当天PCT水平迅速增高，分别为1．6（0．2—10．8）和7．1（1．5～45．2）ng，mL，差异有统计学意义（P〈0．01），而CRP水平分别为75．4（38．0—147．8）和99．3（56．1—163．2）mg／L，差异有统计学意义（P〈0．05）。合并感染患者入住ICU时PCT值高于非感染患者。结论动态监测诊断感染前后PCT水平变化，可以识别创伤患者是否合并感染。入住ICU时PCT水平高的创伤患者合并感染风险大。Objective To compare the value of procalcitonin（PCT） and C-reactive protein（CRP） in early predicating and diagnosing the concurrent infection after severe trauma. Methods Patients who were admitted to the intensive care unit （ICU） in Nanjing hospital affiliated to Nanjing Medical University from January to December in 2012 with severe trauma were taken as research object. The detection of PCT and CRP were collected everyday after the patients hospitalized in ICU. According to the criterion of American College of Chest Physicians,the sepsis,severe sepsis and septic shock were defined. Results The PCT levels of the trauma patients with concurrent infection on 1 day before infection and on the day of diagnosis of infection were both increased rapidly, they were 1.6 （0.2-10.8） ng/ml and 7.1 （1.5-45.2） ng/ml respectively with statistically significant differ- ence （P〈0.01）, while the CRP level on 1 day before infection and on the day of diagnosis of infection was 75.4 （38.0-147.8） mg/L and 99.3 （56.1 - 163.2） mg/L respectively with statistically significant difference （P〈0.05）. The PCT value of the patients with con- current infection after hospitalized in ICU was higher than that of the non-infection individual. Conclusion Dynamically moni- toring and diagnosing the change of PCT before and after infection can indentify whether the concurrent infection appeared. The trauma patients with high level of PCT on admission of ICU have considerable risk of concurrent infection.

关 键 词：创伤和损伤 感染 降钙素 C反应蛋白质 敏感性与特异性 全身炎症反应综合征 

分 类 号：R512.6[医药卫生—内科学]