血浆降钙素原对糖尿病酮症酸中毒患者发生感染的预测效果  

Effect of plasma PCT for forecasting the incidence of infections in patients with diabetic ketoacidosis

作　　者：李文华[1] 李健[2] 梁洁[1] 钟琪[1] 朱丽琼[3] 

机构地区：[1]昆明医科大学附属延安医院老年病科,云南昆明650051 [2]昆明医科大学附属延安医院泌尿科,云南昆明650051 [3]昆明医科大学附属延安医院内分泌科,云南昆明650051

出　　处：《中华医院感染学杂志》2017年第11期2488-2490,2494,共4页Chinese Journal of Nosocomiology

基　　金：昆明市延安医院基金资助项目(Yyky013031)

摘　　要：目的探究血浆降钙素原(PCT)在预测糖尿病酮症酸中毒(DKA)患者合并感染中的应用价值。方法选取2011年3月-2016年6月于医院治疗115例糖尿病酮症酸中毒患者,按照是否发生感染及其程度将115例患者分为糖尿病酮症酸中毒重症感染组25例(重感染组)、局部感染者30例(轻感染组)和无感染者60例(无感染组),另选60例糖尿病无酮症酸中毒患者为对照组,对4组患者入院时、第2天、第3天血浆PCT浓度进行测定,对酮症酸中毒3组患者第1天、第2天血浆PCT浓度水平下降程度进行测定比较,分析酮症酸中毒3组患者不同血浆PCT浓度例数。结果入院时对照组患者血浆PCT浓度(0.22±0.12)ng/ml,重感染组患者(1.29±1.27)ng/ml,轻感染组患者(1.18±1.19)ng/ml,无感染组患者(0.82±0.90)ng/ml,第2天对照组患者血浆PCT浓度(0.17±0.11)ng/ml,重感染组患者(1.13±1.07)ng/ml,轻感染组患者(1.05±1.09)ng/ml,无感染组患者(0.65±0.62)ng/ml,第3天对照组患者血浆PCT浓度(0.12±0.07)ng/ml,重感染组患者(0.93±0.89)ng/ml,轻感染组患者(0.85±0.92)ng/ml,无感染组患者(0.35±0.32)ng/ml,以上重感染组和轻感染组数据和无感染组数据比较差异有统计学意义(P<0.05);血浆PCT浓度在0.50~2.00ng/ml之间的患者三组均在30.00%以上,血浆降钙素原浓度>2.00ng/ml只有重感染组超过50.00%。结论血浆PCT浓度水平对早期糖尿病酮症酸中毒患者发生感染能够起到一定的预测作用,第2天血浆PCT浓度下降量对糖尿病酮症酸中毒患者发生感染能够起到更好的预测作用。OBJECTIVE To explore the value of plasma procalcitonin （PCT） in predicting the infection of patients with diabetic ketoacidosis （DKA）.METHODS A total of 115 cases of diabetic ketoacidosis were selected from Mar.2011 to Jun.2016 in the hospital,and were divided into 25 cases of diabetic ketoacidosis severe infection group （heavy infection group）,30 cases of local infection （light infection group）,and 60 cases without infection （non-infected group） according to whether the infection occurred and the degree,and another 60 cases of diabetes patients without ketoacidosis were selected as control group.The plasma procalcitonin concentrations （PCT） of the four groups of patients on admission,at the second day and the third day were measured,procalcitonin decline concentrations of the three groups with ketoacidosis of the first and the second day in plasma were measured,and the cases with different plasma concentrations of PCT of the 3 groups of patients were analyze.RESULTS On admission,the plasma procalcitonin concentrations were 0.22±0.12 ng/ml in control group,1.29±1.27 ng/ml in heavy infection group,1.18±1.19 ng/ml in light infection group and 0.82±0.90 ng/mL in non infected group.At the second day,the plasma PCT concentrations were 0.17 ±0.11 ng/ml in control group,1.13±1.07 ng/ml in heavy infection group,1.05 ± 1.09 ng/ml in light infection group,and 0.65 ±0.62 ng/ml in non-infected group.At the third day,the plasma PCT concentrations were 0.12 ± 0.07 ng/ml in control group,0.93±0.89 ng/ml in heavy group,0.85±0.92 ng/rnl in light infection group and 0.35±0.92ng in non-infected group.There were significant differences in the plasma PCT concentration among heavy infection group,light infection group and non-infected group （P〈0.05）.The patients with plasma calcitonin in the concentration of 0.5-2 ng/ml of the three groups were all more than 30.00%,and with plasma calcitonin concentration〉 2 ng/ml were only in heavy infection group which were more than 50.00%.CONCLUSION Plas

关 键 词：降钙素原 糖尿病酮症酸中毒 感染 预测 

分 类 号：R446[医药卫生—诊断学]