降钙素原水平改变对类风湿关节炎置换术后早期感染的意义  

Significance of change of procalcitonin level in rheumatoid arthritis patients with early infections after artificial joint replacement

作　　者：柏小金[1] 韩小松[1] 徐林[1] 王世强[1] 杨灿[2] 

机构地区：[1]遵义市第一人民医院骨科,贵州遵义563000 [2]遵义市第一人民医院检验科,贵州遵义563000

出　　处：《中华医院感染学杂志》2017年第6期1317-1320,共4页Chinese Journal of Nosocomiology

基　　金：贵州省科技合作计划基金资助项目(黔科合LH字(2015)7575)

摘　　要：目的研究降钙素原水平变化在类风湿关节炎置换术后早期感染的意义,旨在为患者早期控制感染、阻断疾病演变、降低并发症发生率。方法选取2012年2月至2016年3月类风湿关节炎置换术后感染者20例为感染组,未感染者222例为未感染组,健康体检者48例为对照组。比较术前、术后48h红细胞沉降率(ESR)、白细胞计数(WBC)、C-反应蛋白(CRP)、降钙素原(PCT)水平。结果术前感染组ESR水平为(31.10±7.90)mm/h、CRP为(8.20±2.01)mg/L,未感染组为(33.00±4.00)mm/h、(8.00±1.30)mg/L,均高于对照组(19.50±3.00)mm/h和(5.34±2.20)mg/L,差异有统计学意义(P<0.05);感染组PCT水平为(0.31±0.11)ng/mL、WBC水平为(9.50±3.04)×109/L,未感染组分别为(0.33±0.12)ng/mL、(9.62±3.44)×109/L与对照组(0.24±0.15)ng/mL和(8.23±1.21)×109/L比较,差异无统计学意义;术后48h,感染组、未感染组ESR分别为(69.04±9.80)mm/h、(42.13±11.30)mm/h,PCT为(12.60±1.96)ng/mL、(5.54±3.17)ng/mL,CRP为(23.08±6.87)mg/L、(12.20±3.56)mg/L及WBC为(18.63±4.98)×109/L、(11.98±2.15)×109/L均高于术前,差异有统计学意义(P<0.05);术后48h,感染组ESR、PCT、CRP及WBC水平均高于对照组,差异有统计学意义(P<0.05)。ESR水平敏感度89.58%、PCT91.67%,优于CRP79.17%、WBC60.42%,PCT水平特异性89.18%、阳性预测值67.69%优于ESR、CRP、WBC指标。PCT曲线下面积0.872,截断值10.50ng/mL。结论PCT水平变化有助于类风湿关节炎置换术后早期感染诊断,且PCT的截断值10.50ng/mL,能为临床早期诊断提供参考。OBJECTIVE To observe the significance of change of procalcitonin（PCT）level in rheumatoid arthritis patients with early infections after artificial joint replacement so as to control the early infections,block the evolution of disease,and reduce the incidence of complications.METHODS From Feb 2012 to Mar 2016,totally 20 rheumatoid arthritis patients who had infections after artificial joint replacement were chosen as the infection group,222 patients who did not have infection were assigned as the non-infection group,and 48 healthy people who received physical examination were set as the control group.The erythrocyte sedimentation rate（ESR）,white blood cell（WBC）counts,C-reactive protein（CRP）,and PCT were observed and compared before the surgery and after the surgery for 48 hours.RESULTS The ESR level was（31.10±7.90）mm/h in the infection group before the surgery,（33.00±4.00）mm/h in the non-infection group,higher than（19.50±3.00）mm/h in the control group;the CRP level was（8.20±2.01）mg/L in the infection group before the surgery,（8.00±1.30）mg/L in the non-infection group,higher than（5.34±2.20）mg/L in the control group,and there was significant difference（P〈0.05）.The PCT level was（0.31±0.11）ng/mL in the infection group,（0.33±0.12）ng/mL in the non-infection group,（0.24±0.15）ng/mL in the control group;the WBC level was（9.50±3.04）×10^9/L in the infection group,（9.62±3.44）×10^9/L in the non-infection group,（8.23±1.21）×10^9/L in the control group,and there was no significant difference.The levels of ESR,PCT,CRP,and WBC were respectively（69.04±9.80）mm/h,（12.60±1.96）ng/mL,（23.08±6.87）mg/L,and（18.63±4.98）×10^9/L in the infection group after the surgery for 48 hours and were respectively（42.13±11.30）mm/h,（5.54±3.17）ng/mL,（12.20±3.56）mg/L,and（11.98±2.15）×10^9/L in the non-infection group,higher than those before the surgery,and there was significant difference（P〈0.05）.The levels of ESR,PCT,CRP,and

关 键 词：类风湿关节炎 人工关节置换术 早期感染 降钙素原 

分 类 号：R446[医药卫生—诊断学]