重度缺血性卒中无感染患者的降钙素原动态变化  

Procalcitonin dynamic change of severe ischemic stroke patients without infection

作　　者：高勇[1] 梅丽[2] 王晓静[1] 牛艳慧[1] 王钧[1] 

机构地区：[1]河北省胸科医院ICU,河北石家庄050041 [2]河北省石家庄市第一医院神经内科,河北石家庄050011

出　　处：《河北医科大学学报》2015年第8期887-889,893,共4页Journal of Hebei Medical University

基　　金：河北省医学科学研究重点课题计划(ZD20140378)

摘　　要：目的观察重度缺血性卒中无感染患者5d内降钙素原((proealeitonin,PCT)的动态变化,探讨PCT在重度缺血性卒中早期感染中的诊断价值。方法选取发病24h内不伴感染的重度缺血性卒中患者55例,分别于发病第1、3、5天检测血清PCT、体温、白细胞计数和C反应蛋白(C-reaction protein,CRP)。结果急性重度缺血性卒中后第1、3、5天PCT浓度中位数(四分位数间距)[M(QR)]分别为[0.050(0.04)]μg/L、[0.051(0.02)]μg/L、[0.050(0.002)]μg/L,均较正常上限(0.050μg/L)略升高,差异无统计学意义(P>0.05)。急性重度缺血性卒中后第1、3、5天CRP浓度M(QR)分别为[10.2(2.2)]mg/L、[12.2(4.2)]mg/L、10.0(28.0)mg/L,均较正常上限(5.0mg/L)升高,差异无统计学意义(P>0.05)。体温及白细胞计数无明显升高趋势。急性重度缺血性卒中5d内PCT及CRP均有升高趋势,CRP更为明显,但未达到开始使用抗生素最低值。结论 PCT在急性重度缺血性卒中5d内可升高,但升高幅度较小,故缺血性卒中本身对PCT无影响,PCT可用于缺血性卒中早期合并感染的预测。Objective To study the dynamic change of procalcitonin（PCT）in five days of severe ischemic stroke patients without infection,to further clarify the value of PCT in diagnosis of early infection in severe ischemic stroke.Methods The study involved 55 patients of severe ischemic stroke without infection in 24 hours at the onset,respectively after 1d,3d,5d,the serum PCT,body temperature（T）,white blood cell count（WBC）and C-reaction protein（CRP）were detected.Results Acute severe ischemic stroke after 1 d,3 d,5 d,the median PCT concentration（quartile）0.050（0.04）μg/L,0.051（0.02）μg/L,0.050（0.002）μg/L were slightly higher than normal line（0.050μg/L）,but there were no significant difference（P〉0.05）.Acute severe ischemic stroke after 1d,3d,5d,the median CRP concentration（quartile）10.2（2.2）mg/L,12.2（4.2）mg/L,10.0（2.8）mg/L,were higher than normal line 5 mg/L increased,there were no significant difference（P〉0.05）.There were no significant increase in T and WBC.Acute severe ischemic stroke within 5days,PCT and CRP both showed rise trend,and CRP was more obvious,but did not reach the minimum value as the beginning using antibiotics.Conclusion PCT in acute ischemic stroke within 5days can be increased,but increased less,no statistical significance,the ischemic stroke itself had no effect on PCT,PCT can be used to predict the early stage of ischemic stroke complicated with infection.

关 键 词：卒中 降钙素原 C反应蛋白质 感染 

分 类 号：R743[医药卫生—神经病学与精神病学] R446.62[医药卫生—临床医学]