清蛋白与前清蛋白和C-反应蛋白检测对普外科患者术后感染的诊断研究  

Detection of albumin,prealbumin and C-reactive protein in diagnosis of infections in department of general surgery patients after operation

作　　者：张会英 袁培江 源洋 贾俊 李中正 ZHANG Hui-ying YUAN Pei-jiang YUAN Yang JIA Jun LI Zhong-zheng(Nanyang Hospital of Traditional Chinese Medicine, Nanyang, Henan 473000, Chin)

机构地区：[1]河南省南阳市中医院外一科,河南南阳473000

出　　处：《中华医院感染学杂志》2017年第20期4716-4719,共4页Chinese Journal of Nosocomiology

摘　　要：目的探讨清蛋白、前清蛋白和C-反应蛋白检测在普外科患者术后手术部位感染的诊断价值。方法选择医院2014年2月-2016年2月普外科手术患者320例,所有患者术前均确诊无感染,分别于术后12、24h、3d和7d取血标本检测清蛋白、前清蛋白和C-反应蛋白(CRP),监测所有患者于术后7d内是否发生感染;根据诊断结果将患者分为感染组27例和未感染组293例,比较两组术前、术后不同时间点的清蛋白、前清蛋白和CRP水平。结果术后发生感染患者27例,感染率8.44%,共检出病原菌36株,其中革兰阴性菌10株占27.78%,革兰阳性菌16株占44.44%,真菌10株占27.78%;两组患者清蛋白、前清蛋白、CRP在术前2h比较差异均无统计学意义,两组术后12、24h、3d、7d感染组患者清蛋白、前清蛋白、CRP明显低于术前,且感染组患者明显低于未感染组(P<0.05),两组患者术后12、24h、3d、7dCRP均明显高于术前2h,且感染组明显高于对照组(P<0.05);清蛋白、前清蛋白、CRP、清蛋白+前清蛋白、清蛋白+CRP、前清蛋白+CRP、清蛋白+前清蛋白+CRP 7种诊断方案对患者术后感染的诊断敏感度、特异度比较,以清蛋白+前清蛋白+CRP方案的诊断敏感度、特异度最佳。结论采用清蛋白+前清蛋白+CRP实验数据诊断普外科患者术后手术部位感染,时效性和客观性均较好,具有一定的临床价值。OBJECTIVE To analyze the diagnostic value of detection of albumin,prealbumin and C-reactive protein（CRP）in surgical site infections in department of general surgery patients after operation.METHODS A total of 320 cases of general surgery patients with operation from Feb.2014 to Feb.2016 were selected.All the patients were diagnosed without infections.Blood samples were taken at postoperative 12 h,24 h,3 d and 7d for detection of albumin,prealbumin and CRP,respectively.All patients were monitored for infections within 7d after operation.According to the results of the diagnosis,the patients were divided into infection group（27 cases）and non-infection group（293 cases）,and the levels of albumin,prealbumin and CRP at different time points before and after operation between the two groups were compared.RESULTS There were 27 cases of postoperative infections,and the infection rate was 8.44%.Totally 36 strains of pathogens were detected,of which 10 strains were gram-negative,accounting for 27.78%,16 strains were gram-positive,accounting for 44.44%,and 10 strains were fungi,accounting for 27.78%.The levels of albumin,prealbumin and CRP in preoperative 2 h between the two groups showed no significant difference.The levels of albumin,prealbumin and CRP at postoperative 12 h,24 h,3 d and 7 d of the two group were significantly lower than those before operation,and those in infection group were significantly lower than in non-infection group（P〈0.05）.The levels of CRP at postoperative 12 h,24 h,3 d and 7 d of the two group were significantly higher than those at preoperative 2 h,and that in infection group was significantly higher than in non-infection group（P〈0.05）.Comparison of the sensitivity and specificity of 7 diagnostic schemes of albumin,prealbumin,CRP,albumin ＋ prealbumin,albumin ＋ CRP,prealbumin ＋ CRP and albumin＋prealbumin＋CRP in the diagnosis of postoperative infection,albumin＋prealbumin＋CRP had the best sensitivity and specificity.CONCLUSION Using albumin＋prealbumin＋CRP e

关 键 词：普外科 手术部位感染 清蛋白 前清蛋白 CRP 诊断价值 

分 类 号：R619.3[医药卫生—外科学]