联合检测C反应蛋白和降钙素原在创伤后脓毒症患者早期预警中的作用  

Combined detection of C-reactive protein and procalcitonin in early prediction of patients with post-traumatic sepsis

作　　者：文大林 杜娟 陈民佳 孙剑会 张华才 张安强 都定元 WEN Da-lin;DU Juan;CHEN Min-jia;SUN Jian-hui;ZHANG Hua-cai;ZHANG An-qiang;DU Ding-yuan(Chongqing Emergency Medical Center,Central Hospital of Chongqing University,Chongqing 400014;State Key Laboratory of Trauma,Burns and Combined Injury,Daping Hospital,Army Medical University,Chongqing 400042,China)

机构地区：[1]重庆大学附属中心医院重庆市急救医疗中心,重庆400014 [2]陆军军医大学大坪医院创伤、烧伤与复合伤国家重点实验室,重庆400042

出　　处：《基础医学与临床》2020年第2期178-181,共4页Basic and Clinical Medicine

基　　金：全军医学科技青年培育项目(17QNP005);国家“十二五”科技支撑计划(2012BAI11B01)

摘　　要：目的评估血清C反应蛋白(CRP)和降钙素原(PCT)联合检测对创伤后脓毒症患者的预警价值。方法纳入严重创伤患者235例,其中110例脓毒症患者和125例非脓毒症患者。采集入院24 h内血样,检测血清中CRP和PCT。采用ROC曲线比较CRP和PCT对创伤后脓毒症的预警价值,同时采用NRI和IDI分析联合使用后的提高能力。结果脓毒症患者血清CRP和PCT水平均显著高于非脓毒症患者(P<0.001),ROC分析显示血清CRP和PCT的AUC分别为0.766(0.707~0.819)和0.744(0.684~0.799);将CRP和PCT联合较单指标预警创伤脓毒症的AUC提高了5.1%,7.3%。NRI和IDI分析结果证实PCT和CPR的联合使用较单独使用的预警效能显著提高(P<0.001)。结论CRP和PCT对严重创伤后脓毒症发生风险具有早期预警作用,二者联合能够显著提高早期预警能力。Objective To evaluate the value of combined detection of serum C-reactive protein(CRP)and procalcitonin(PCT)for early warning of traumatic sepsis.Methods Two hundred and thirty five patients with severe trauma were included,including 110 patients with sepsis and 125 patients with non-sepsis.Blood samples were collected in 24 hours of admission and serum CRP and PCT were measured.The ROC curve was used to compare the early warning value of CRP and PCT for post-traumatic sepsis,and the improvement ability after combined use of NRI and IDI was analyzed.Results The results showed that CRP and PCT in patients with post-traumatic sepsis were significantly higher than those in non-sepsis patients(P<0.001).ROC analysis revealed that the AUC of serum CRP and PCT were 0.766(0.707-0.819)and 0.744(0.684-0.799),respectively;The AUC of CRP and PCT combined with single-label early warning trauma sepsis was increased by 5.1%,7.3%.Meanwhile,the results of NRI and IDI analysis also suggested the combination of CRP and PCT was sensitive to identify the patients with high risk of sepsis(P<0.001).Conclusions CRP and PCT have early prediction effects on the risk of sepsis in major trauma patients.Combination of CPR and PCT can significantly improve early prediction ability.

关 键 词：创伤脓毒症 C反应蛋白 降钙素原 早期预警 

分 类 号：R446.1[医药卫生—诊断学]