降钙素原测定在老年腹部外科手术后肺部感染中的早期临床诊断价值研究  

The diagnostic value of early clinical research procalcitonin in pulmonary infections after abdominal surgery in elderly

作　　者：黄威[1] 王理[1] 吕程[1] 罗灿军[1] 金河[1] 方凌云[1] 王梦炎[1] 

机构地区：[1]安徽医科大学解放军113临床学院中国人民解放军第113医院普外科,浙江宁波315040

出　　处：《中国医学前沿杂志（电子版）》2017年第1期131-134,共4页Chinese Journal of the Frontiers of Medical Science(Electronic Version)

摘　　要：目的探讨老年腹部外科手术后应用降钙素原(proealeitonin,PCT)诊断肺部感染的临床价值,为早期临床诊断提供参考依据。方法选取2012年10月至2015年10月于本院实施腹部外科手术治疗的老年患者98例为研究对象,其中,感染者42例(感染组),未感染者56例(未感染组),随机选择同期30例健康人纳入对照组,动态观察术后1、5、9天感染组和未感染组患者PCT、C反应蛋白(C reactive protein,CRP)以及白细胞(white blood cell,WBC)计数的变化情况,并评价上述3种指标诊断肺部感染的敏感性和特异性。结果感染组患者术后PCT水平明显增高,术后9天恢复正常;未感染组患者入院时PCT水平正常,仅于术后轻度升高,术后9天恢复正常。术后9天两组患者PCT水平比较差异具有显著性(P<0.01)。术后1天,感染组与未感染组患者PCT、CRP水平及WBC计数均明显高于对照组(P<0.01),感染组与未感染组患者上述指标比较均无显著差异(P>0.05);术后5天和9天,感染组患者PCT和CRP水平均明显高于未感染组(P<0.01,P<0.05);术后5天,感染组患者WBC计数明显高于未感染组(P<0.05);术后9天,感染组患者与未感染组患者WBC计数比较差异无显著性(P>0.05)。PCT诊断的敏感性和特异性分别为86.9%和89.1%,均明显高于CRP和WBC诊断。结论 PCT可作为老年腹部外科手术后肺部感染的早期诊断标准,其敏感性和特异性均高于CRP、WBC。Objective To investigate the clinical value of procalcitonin（PCT） in the diagnosis of pulmonary infection after abdominal surgery in elderly patients, and to provide a reference basis for early diagnosis. Method A total of 98 elderly patients with abdominal surgery in our hospital from October 2012 to October 2015 were selected and divided into infection group（42 cases） and uninfected group（56 cases）, while 30 cases of healthy people selected as control group. The levels of PCT, C reactive protein（CRP） and white blood cell（WBC） count were determined and compared between the two groups 1 day, 5 days and 9 days after operation; the sensitivity and specificity of the three indicators in the diagnosis of infections were evaluated. Result Serum PCT level limited increased in infection group after operation, and recovered after infection controlled. The uninfected group serum PCT level transient increased after operation and fell down 9 days after operation. 9 days after operation, there was significant difference in PCT level between the two groups（P〈0.01）. 1 day after operation, the levels of PCT, CRP, and WBC count of infection group and uninfection group were significantly higher than those of control group（P〈0.01）, however, there were no significant differences in the levels of PCT, CRP and WBC count between infection group and uninfection group（P〉0.05）. 5 days and 9 days after operation, the levels of PCT and CRP of infection group were significantly higher than those of uninfection group（P〈0.01, P〈0.05）. 5 days after operation, WBC count of infection group were significantly higher than those of uninfection group（P〈0.05）, 9 days after operation, WBC count of infection group were not significantly higher than those of uninfection group（P〉0.05）. The sensitivity and specificity of the PCT in diagnosis of the postoperative infections were respectively 86.9% and 89.1%, significantly higher than those of the CRP and WBC. Conclusion PCT can be used as a standard

关 键 词：老年 降钙素原 肺部感染 

分 类 号：R656[医药卫生—外科学] R563.1[医药卫生—临床医学]