慢加急性肝衰竭患者血清降钙素原检测的临床意义  

Clinical significance of serum procalcitonin in patients with acute-on-chronic liver failure

作　　者：郭倩[1] 武淑环[1] 张红宇[1] 李志勤[1] 李华[1] 李建[1] 

机构地区：[1]郑州大学第一附属医院感染科,450052

出　　处：《中国实用医刊》2015年第7期21-22,共2页Chinese Journal of Practical Medicine

摘　　要：目的 探讨慢加急性肝衰竭（ACLF）患者血清降钙素原（PCT）水平的变化及其临床意义.方法 选择ACLF患者123例,分别检测入院当天PCT、C-反应蛋白（CRP）、白细胞（WBC）及入院1周及出院前PCT水平,并进行MELD-Na评分.结果 ①入院当天感染组PCT值明显高于无感染组（P＜0.05）,各组入院当天与1周及出院前PCT值比较差异均有统计学意义（P＜0.05）;②血清PCT对感染诊断的敏感性为（95.23％,60/63）,特异性为（100％,60/60）,敏感性及特异性均高于WBC及CRP（P ＜0.01）;③死亡组患者血清PCT阳性率、血清PCT水平均高于存活组（P＜0.05）;MELD-Na评分＞30分组患者血清PCT水平高于MELD-Na评分＜30分组（P＜0.05）.结论 血清PCT测定对慢加急性肝衰竭并发感染早期诊断及判断预后具有重要意义.Objective To investigate the changes and the clinical significance of serum procalcitonin （PCT） in patients with acute-on-chronic liver failure （ACLF）.Methods The 123 patients with ACLF were analyzed.Regisiter the MELD-Na score and measure the levels of PCT,WBC and CRP of the first day,and measure the levels of the PCT of the seven day and the last day in hospital.Results ① PCT levels in bacterial group were higher than in non-bacterial infection group （P 〈 0.05）,PCT levels at first of admission was higher than that on the seventh day and that on the last day in hospital in all three groups （P 〈 0.05）.②The sensitivity （60/63） for the specificity of PCT was 95.23 % for the diagnosis of patients with bacterial peritonitis.The specificity （60/60） was 100%.They were better than WBC and CRP.③Patients in death group had a higher positive rate and a higher value of PCT than those in survival group（P 〈 0.05）.Patients in MELD-Na score 〉 30 group had a higher PCT level than those in MELD-Na score 〈 30 group （P 〈 0.05）.Conclusions The value of PCT may be helpful in predicting the severity of the illness and prognosis in patients with ACLF.

关 键 词：慢加急性肝衰竭 血清降钙素原 细菌感染 

分 类 号：R51[医药卫生—内科学]