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·腹部疾病·

严重多发伤早期感染患者血清降钙素原与C-反应蛋白水平检 测意义研究

作者:吕燕海 周明欣 容 冰

所属单位:广东省茂名高州市中医院检验科 (广东 茂名 525200)

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摘要

目的 探讨严重多发伤早期感染患者血清降钙素原(PCT)与C-反应蛋白(CRP)水平的检测意义。方法 回顾性分析2013 年6月至2015年6月于我院救治的64例严重多发伤患者的临床资料,依据患者是否出现感染分为观察组(有感染,32 例)和对照组(未感染,32例)。检测两组患者入院后不同时间点的血清PCT及CRP水平,通过比较血清PCT及CRP水平 变化及患者PCT与CRP阳性率来评估其对检测严重多发伤患者是否出现感染的临床价值。结果 入院5d、7d后观察组 CRP水平(157.82±42.38)mg/L、(167.82±40.23)mg/L均较对照组(108.64±32.11)mg/L、(112.30±28.93)mg/L显 著较高(P<0.05)。随着入院时间的推移,两组患者血清PCT水平均呈上升的趋势,观察组入院5d、7d后PCT水平为 (29.73±17.64)ng/mL、(36.58±12.64)ng/mL较对照组(1.55±0.27)ng/mL、(1.63±0.37)ng/mL显著较高,组间差 异有统计学意义(P<0.05)。观察组患者入院1周PCT及CRP阳性率为93.75%、90.63%均较对照组12.50%、18.75%显著 较高(P<0.05)。结论 严重多发伤早期感染患者会出现血清降钙素原与C-反应蛋白水平的异常增高;因而,测定血 清降钙素原与C-反应蛋白水平对临床上判断严重多发伤患者是否并发早期感染具有一定的检测价值。

Objective To study the the test significance of procalcitonin (PCT) and C- reactive protein (CRP) for early infection in patients with severe multiple injuries. Methods From Jun. 2013 to Jun. 2015, a total of 64 patients with severe multiple injuries in our hospital were taken as the clinical research objects, and they were divided into observation group (32 cases, infection) and control group (32 cases, uninfection). After admission, tests of PCT and CRP serum levels in these two groups were made at different time in order to find their clinical value for early infection in patients with severe multiple injuries by comparing the changes of PCT and CRP serum levels and the positive rates of PCT and CRP. Results 5 and 7 days after admission, the CRP levels in the observation group were respectively (157.82±42.38)mg/ L and (167.82±40.23)mg/L which were significantly higher than those in the control group (108.64±32.11)mg/L and (112.30±28.93)mg/L (P<0.05), the serum levels of PCT showed an upward tendency in these two groups as time went on. 5 and 7 days after admission, the PCT levels in the observation group were respectively (29.73±17.64)ng/mL and (36.58±12.64)ng/mL which were significantly higher than those in the control group (1.55±0.27)ng/mL and (1.63±0.37) ng/mL (P<0.05). 1 week after admission, the positive rates of PCT and CRP in the observation group were respectively 93.75% and 90.63% which were significantly higher than those in the control group 12.50% and 18.75%(P<0.05). Conclusion The early infection can cause abnormal increase of PCT and CRP serum levels in patients with severe multiple injuries. Therefore, the test of PCT and CRP serum levels in patients with severe multiple injuries has a certain value to determine whether the early infection exists.

【关键词】严重多发伤;早期感染;PCT;CRP

【中图分类号】R63

【文献标识码】A

【DOI】10.3969/j.issn.1009-3257.2016.05.018

前言

多发伤主要指单一致同时或相继引起机体多个解 剖部分的创伤,若患者至少有一个损伤部位被判定为 致命伤,则判定患者病情严重,称为严重多发伤[1]。 大量实验资料显示,严重多发性伤患者易出现医院感染,造成预后不良,严重影响到患者的身心健康[2]。 因而,早期确诊并采取有效抗炎措施对提高严重多发 伤临床疗效极为重要。现将64例严重多发伤患者作为 研究对象,回顾性分析其临床资料,分析血清PCT及CRP水平变化与患者发生感染的相关性。结果如下。