血清降钙素原与失血性休克患者早期感染的相关性分析  

Correlation Between Serum Procalcitonin and Early Infection in Patients with Hemorrhagic Shock

作　　者：林幼萍 张加乐 邓明汉 宋艳娟 LIN Youping;ZHANG Jiale;DENG Minghan;SONG Yanjuan(Department of Critical Care Medicine,Binhaiwan Central Hospital of Dongguan City,Dongguan 523900,Guangdong,China;Department of Infectious Diseases,Binhaiwan Central Hospital of Dongguan City,Dongguan 523900,Guangdong,China)

机构地区：[1]东莞市滨海湾中心医院重症医学科,广东东莞523900 [2]东莞市滨海湾中心医院感染科,广东东莞523900

出　　处：《现代诊断与治疗》2023年第8期1116-1119,共4页Modern Diagnosis and Treatment

基　　金：东莞市社会科技发展(一般)项目(202050715025600)。

摘　　要：目的 分析血清降钙素原(Procalcitonin,PCT)与失血性休克患者早期感染的相关性。方法 回顾性分析2017年1月至2019年12月期间本院重症医学科收治的116例失血性休克患者的临床资料,根据入院7 d内是否合并感染分为早期感染组(45例)和非感染组(71例),比较两组患者入院当天D0、D1、D2、D3、D5、D7血清炎症因子[PCT、C反应蛋白(C-reactive protein,CRP)]、通过受试者工作特征曲线(Receiver operating Characteristic,ROC)分析D0、D1、D2血清PCT水平对失血性休克患者早期感染的诊断价值。结果 两组患者D0 PCT及D0、D1、D3、D5、D7 CRP水平比较,无显著差异(P>0.05);早期感染组D1、D2、D3、D5、D7 PCT及D2 CRP显著高于非感染组,差异有统计学意义(P<0.05);早期感染组PCT水平于D2达高峰,非感染组PCT水平于D1达高峰;ROC曲线分析结果显示,D0、D1、D2血清PCT诊断失血性休克患者早期感染的曲线下面积(AUC)分别为0.507、0.676、0.759,95%置信区间分别为0.413~0.601、0.583~0.760、0.670~0.833,敏感度分别为31.11%、71.11%、82.22%,特异度分别为97.18%、57.75%、60.56%,最佳截断值分别为1.39、7.92、8.50;不同时间血清PCT诊断失血性休克患者早期感染的AUC比较:D2>D1>D0。结论 早期动态监测PCT对失血性休克患者是否合并感染具有一定指导意义,但不能单凭入院当天血清PCT水平判断,还需结合患者的临床症状及其他相关检查进行综合评估。Objectives To analyze the correlation between serum procalcitonin(PCT) and early infection in patients with hemorrhagic shock.Methods The clinical data of 116 patients with hemorrhagic shock admitted to the Department of Critical Care Medicine in our hospital from January 2017 to December 2019 were retrospectively analyzed.According to whether they were complicated with infection within 7 days of admission,the patients were divided into early infection group(45 cases) and non-infection group(71 cases).Serum inflammatory factors [PCT and C-reactive protein(CRP)] were compared between the two groups on the day of admission(D0),D1,D2,D3,D5and D7.The receiver operating characteristic(ROC) curve was used to analyze the diagnostic value of serum PCT levels at D0,D1 and D2 on early infection in patients with hemorrhagic shock.Results There was no significant difference in PCT level at D0 and CRP levels at D0,D1,D3,D5 and D7 between the two groups(P<0.05).The PCT at D1,D2,D3,D5 and D7,and CRP at D2 in early infection group were significantly higher than those in non-infection group(P<0.05).The PCT level in early infection group peaked at D2 while that in non-infection group peaked at D1.The results of ROC curve analysis showed that the areas under the curve(AUC) of serum PCT at D0,D1 and D2 in the diagnosis of early infection in patients with hemorrhagic shock were 0.507,0.676 and 0.759,respectively.The 95% confidence intervals(CI) were 0.413~0.601,0.583~0.760 and 0.670~0.833,respectively.The sensitivity was 31.11%,71.11% and 82.22%,respectively,and the specificities were 97.18%,57.75% and 60.56%,respectively.The optimal cut-off values were 1.39,7.92 and 8.50,respectively.Comparison of AUC of serum PCT in the diagnosis of early infection in patients with hemorrhagic shock at different time was D2D1D0.Conclusions Early dynamic monitoring of PCT has certain guiding significance for whether patients with hemorrhagic shock are complicated with infection,but it cannot be judged solely by serum PCT level on the day of admissio

关 键 词：血清降钙素原 失血性休克 早期感染 相关性分析 

分 类 号：R649.9[医药卫生—外科学]