血清C-反应蛋白与降钙素原用于评估抗生素治疗妇科肿瘤术后厌氧菌盆腔感染的价值  

Value of serum C-reactive protein and procalcitonin in assessment of treatment of postoperative anaerobic bacteria pelvic infections of gynecological tumor patients with antibiotics

作　　者：吕竞[1] 詹继东[1] 叶青[2] LYU Jing;ZHAN Ji-Dong;YE Qing(Hospital Attached to Huazhong University of Science and Technology Wuhan,Hubei 430074,China)

机构地区：[1]华中科技大学医院超声影像科,湖北武汉430074 [2]华中科技大学医院内科,湖北武汉430074

出　　处：《中华医院感染学杂志》2019年第24期3809-3813,共5页Chinese Journal of Nosocomiology

基　　金：武汉市科技局科技发展基金资助项目(279618)

摘　　要：目的探究血清C-反应蛋白(C-reactive protein,CRP)及降钙素原(Procalcitonin,PCT)用于评价妇科肿瘤术后厌氧菌性盆腔感染抗菌药物使用疗效的价值,为临床合理选取抗菌药物提供依据。方法选取2015年6月-2018年3月华中科技大学附属医院接诊的妇科肿瘤术后厌氧菌性盆腔感染患者120例,采用简单随机数字表法将患者分为观察A组与观察B组,观察A组采用奥硝唑治疗,观察B组采用甲硝唑治疗,另选取同期健康体检者50名作为对照组,检测比较三组受试者治疗前后血清CRP、PCT的变化,对比两组患者的治疗疗效。结果观察A组治疗的总有效率为95.00%,观察B组的总有效率为81.67%,观察A组治疗总有效率高于观察B组,差异具有统计学意义(χ~2=12.324,P=0.002)。治疗后,观察A组CRP水平较对照组高(P=0.002);观察B组血清PCT及CRP水平与对照组相比,无统计学差异(P=0.305,0.107);观察A组与观察B组血清PCT及CRP水平均较治疗前降低,差异具有统计学意义(P<0.05),且观察B组下降水平低于观察A组,差异具有统计学意义(P<0.05)。血清PCT、CRP联合检测诊断盆腔感染的灵敏度和特异度高于单个指标检测的灵敏度和特异度。结论血清CRP、PCT的变化不仅可用来判断患者感染情况的变化,还可用来为更好选取抗菌药物提供依据。临床上血清PCT、CRP可用于厌氧菌性盆腔感染诊断和治疗疗效评估的一项参考指标。OBJECTIVE To explore the value of serum C-reactive protein(CRP) and procalcitonin(PCT) in evaluating the efficacy of antibiotics for anaerobic pelvic infections, in order to provide a basis for clinical rational selection of antibacterials. METHODS Total of 120 patients with anaerobic pelvic infection after gynecologic oncology surgery in Hospital Attached to Huazhong University of Science and Technology from June 2015 to March 2018. The patients were divided into group A and group B by using simple random number tables. Group A was treated with ornidazole and group B was treated with metronidazole. The other 50 healthy subjects were recruited as the control group. The variation levels of serum CRP and PCT among the three groups were compared before and after the treatment. The indexes were also compared between group A and group B. RESULTS The total effective rate in group A(95.00%) was significantly higher than that in group B(81.67%)(χ~2=12.324,P=0.002). After the treatment, the levels of serum CRP in group A were significantly higher than that in the control group(P=0.002). The levels of serum PCT and CRP between group B and the control group did not have significant difference(P=0.305,0.107). The levels of serum PCT and CRP in both group A and group B after the treatment were significantly lower than that before the treatment(P<0.05). Besides, the differences of the declines in serum PCT and CRP levels in group B were significantly lower than that in group A(P<0.05). The sensitivity and specificity of the method, which combined the detection of serum PCT and CRP in the diagnosis of pelvic infection were higher than the detection of serum PCT or CRP only. CONCLUSION Variations in serum CRP and PCT can be used not only to supervise the patient’s infection, but also to provide a basis for the better selection of antimicrobial agents. Combined detection of serum PCT and CRP can be used as a reference assay for the diagnosis and therapeutic evaluation of anaerobic pelvic infections clinically.

关 键 词：C-反应蛋白 降钙素原 盆腔感染 疗效 

分 类 号：R713[医药卫生—妇产科学]