降钙素原对重症脑损伤继发肺部感染的早期诊断价值  

Early diagnosis value of procalcitonin in severe brain damage combined with pulmonary infection

作　　者：韦巍[1] 陈金月[2] 曾清[3] 冯春晓[3] 李敏[1] 李明芬[1] 

机构地区：[1]广西中医药大学第一附属医院检验科,广西南宁530021 [2]广西中医药大学第一附属医院药学部,广西南宁530021 [3]广西中医药大学第一附属医院血液病科,广西南宁530021

出　　处：《国际检验医学杂志》2015年第20期2934-2936,共3页International Journal of Laboratory Medicine

基　　金：广西壮族自治区卫生厅课题(Z2014107)

摘　　要：目的探讨降钙素原（PCT）对脑损伤患者继发肺部感染的早期诊断价值,并与其他炎性指标比较。方法选取2014年1～10月该院因严重脑损伤入院的患者,入院5d后发生感染者为感染组,未发生感染者为未感染组。于入院2h内及入院后第3天采集血样,检测PCT水平,考察PCT对脑损伤合并肺部感染的早期诊断价值,并与白细胞（WBC）计数、中性粒细胞数（N）和超敏C反应蛋白（hs-CRP）等指标进行比较。结果重症脑损伤后5d内肺部感染发生率为22.9%（41/179）。合并感染组与未感染组间PCT、WBC、N和hs-CRP进行比较,差异有统计学意义（P〈0.05）。绘制受试者工作特征曲线（ROC曲线）,PCT、WBC、N和hs-CRP的曲线下面积（AUC）分别为：0.83、0.80、0.78、0.82,PCT＋WBC＋hs-CRP组合的诊断价值最高,AUC为0.87。PCT对脑损伤合并肺部感染的灵敏度、特异度和阳性预测值较高,具有一定的诊断准确性。结论 PCT对重症脑损伤患者合并肺部感染有较高的早期诊断价值,与WBC和hs-CRP联合应用则诊断准确性更高。临床工作中对PCT升高尤其是WBC、hs-CRP也升高的脑损伤患者,应考虑使用抗菌药物干预。Objective To evaluate the early diagnosis value of procalcitonin （PCT） in severe brain damage combined with pul‐monary infection .Methods The brain injury patients in the hospital from January to October 2014 were enrolled in the study and divided into infectious group whose infection had occurred within 5 days after admitting to hospital and non‐infectious group who had not suffered from infection .The blood samples of the patients were collected within 2 h and 3 days after admitting to hospital and detected for PCT concentration .The Early diagnosis value of PCT in brain damage combined with pulmonary infection was e‐valuated and compared with white blood cells （WBC） ,neutrophile granulocyte（N）and hypersensitive C‐reactive protein（hs‐CRP） . Results The incidence of pulmonary infection within 5 days of severe brain injury was 22 .9% （41/179） .There were statistically differences of PCT ,WBC ,N and hs‐CRP between infectious group and non‐infectious group（P〈 0 .05） .The areas under curve （AUC） of PCT ,WBC ,N and hs‐CRP were 0 .83 ,0 .80 ,0 .78 and 0 .82 respectively .The combination of PCT＋WBC＋ hs‐CRP had the highest diagnostic value since its AUC was 0 .87 .PCT had a satisfied diagnostic veracity since it had good sensitivity ,specificity and positive predictive value in the diagnosis of brain damage combined with pulmonary infection .Conclusion PCT could be an ear‐ly diagnosis indicator in severe brain damage combined with pulmonary infection ,and the diagnostic veracity is higher when com‐bined with WBC and hs‐CRP .An antimicrobial treatment is recommended when PCT concentration of brain damage patient rises , especially when combined with WBC and hs‐CRP concentration elevating .

关 键 词：降钙素原 炎性指标 脑损伤 感染 

分 类 号：R651.15[医药卫生—外科学]