72h内动态监测降钙素原在急性脑卒中并发感染患者中的应用研究  

Application of 72h dynamic monitoring of procalcitonin in patients with acute stroke complicated with infections

作　　者：刘福英[1] 罗勇[1] 冯飞[1] 李静[1] 杨灿[2] 宫敏敏 

机构地区：[1]遵义市第一人民医院神经内科,贵州遵义563000 [2]遵义市第一人民医院检验科,贵州遵义563000 [3]遵义医学院第一附属医院重症医学科,贵州遵义563000

出　　处：《中华医院感染学杂志》2017年第19期4416-4419,共4页Chinese Journal of Nosocomiology

摘　　要：目的探讨72h内动态监测血清降钙素原(PCT)在急性脑卒中并发感染患者中的应用价值。方法选取在2012年3月-2017年2月医院收治的急性脑卒中患者103例,根据微生物学检查结果分为感染组42例与非感染组61例,比较观察两组患者在24h、36h、72h的血清降钙素原(PCT)变化在病理因素中的差异及对病情的影响。结果 103例脑卒中患者中有42例患者并发感染,感染率为40.78%,其中两组患者的年龄、合并症种类、病灶体积及美国国立卫生研究院卒中量表(NIHSS)评分均有显著差异(P均<0.05);感染组患者的PCT在24h、36h、72h的检测结果分别为(1.447±0.083)μg/L、(4.926±0.376)μg/L、(9.238±1.652)μg/L明显高于非感染组(0.354±0.027)μg/L、(3.071±0.238)μg/L、(5.636±0.794)μg/L(P均<0.05);NIHSS中度和重度的感染组患者在72h内各时间点的PCT检测数值与非感染组患者之间存在差异(P均<0.05),而评分轻度患者组间PCT检查结果未见明显差异;感染组患者的死亡率为26.19%明显高于非感染组的3.28%(P均<0.05)。结论急性脑卒中并发感染患者的PCT数值显著升高,指标水平越高反映病情越重,在72h内动态检测PCT对脑卒中患者的诊断和预后都具有一定的临床价值。OBJECTIVE To explore the application value of 72 hdynamic monitoring of serum procalcitonin（PCT）in patients with acute stroke complicated with infections.METHODS A total of 103 patients with acute stroke admitted in our hospital from Mar.2012 to Feb.2017 were retrospectively selected.According to the results of microbiological examination,the patients were divided into infected group of 42 cases and the non-infected group of61 cases.The differences of the serum procalcitonin（PCT）changes in pathological factors and the effect on the disease of the two groups at 24 h,36hand 72 hwere compared.RESULTS Among the 103 patients with stroke,42 patients were infected,and the infection rate was 40.78%.There were significant differences in age,complication type,lesion volume and National Institute of Health Stroke Scale（NIHSS）score between the two groups（P〈0.05）.The detection results of PCT in infected group were（1.447±0.083）μg/L,（4.926±0.376）μg/L and（9.238±1.652）μg/L at 24 h,36hand 72 h,which were significantly higher than（0.354±0.027）μg/L,（3.071 ±0.238）μg/L and（5.636±0.794）μg/L in non-infected group,（P〈0.05）.There were significant differences in PCT detection results at all time points of 72 hours of patients with moderate and severe NIHSS score in infected group and non-infected group（P〈0.05）,and there were no significant differences in mild NIHSS score groups.The mortality rate of infected group was 26.19%,which was significantly higher than 3.28% of non-infected group（P〈0.05）.CONCLUSION The level of PCT in patients with acute stroke complicated with infections will significantly increase,and the higher the index level,the more severe the disease.The 72 hdynamic detection of PCT has a certain clinical valuein diagnosis and prognosis of patients with stroke.

关 键 词：脑卒中 并发感染 PCT 72h内动态检测 应用价值 

分 类 号：R743[医药卫生—神经病学与精神病学]