摘要
目的探讨降钙素原（PCT）对早期诊断体外循环（CPB）心脏直视术后细菌感染及判断严重程度的价值。方法随机选取我院心脏外科2014年4月至2015年3月在CPB下行心脏直视手术的患者197例，测定患者手术当天，术后第1、2、3天血PCT浓度。根据患者临床表现及细菌培养结果将患者分为无细菌感染组和细菌感染组，观察两组患者PCT浓度的变化规律并进行比较。结果无细菌感染组PCT在术后第1天达到峰值为（1．50±1．26）ng／ml，第2、3天逐渐下降；细菌感染组PCT浓度高于无细菌感染组，两组比较差异有统计学意义（P〈0．01），且在术后早期持续升高或下降后再次升高出现第二个峰值（〉5．0ng／m1）。7例全身细菌感染患者的PCT峰值均〉10ng／ml。结论PCT对体外循环心脏术后细菌感染有良好的诊断价值。如患者术后PCT〉5．0ng／ml或术后早期持续升高或下降后再次升高，则高度提示患者发生细菌感染，感染严重程度与PCT增高程度呈正相关。
Objective To explore the the value of Procalcitonin（PCT） in early diagnosis of bacteria infec- tion, and judge the severity of patients who got cardiac surgery under Cardiopulmonary bypass（CPB）. Methods The research objects were randomly selected from the patients with cardiac operation under CPB in April 2014 to March 2015 in our hospital. The blood concentration of PCT of postoperative patients was determined in the day after surgery, 1 day after surgery, 2 days after surgery and 3 days after surgery. According to the clinical presentation and bacterial culture results, the cases were divided into non bacterial infection and bacterial infection groups. The variation law of two groups of PCT concentration were observed and compared. Results PCT concentrations in non bacterial infection group were up to peak（ 1.50±1.26）ng/ml in 1 day after surgery, then decreased gradually in 2 or 3 days. PCT concentrations in bacterial infection group were higher than the other group （P〈0.01）, and continued to rise or fall to rise again appearing the second peak in early postoperative days（peak concentration〉5.0 ng/ml）. 7 cases of patients with systemic bacterial infection of PCT were 〉10 ng/ml. Conclusion PCT shows a good diag- nostic value in early diagnosis of postoperative bacterial infection of cardiac surgery under CPB. Postoperative pa- tients with PCT〉5.0 ng/ml or continue to rise, or fall to rise again, highly suggest a bacterial infection, the degree of infection was positively associated with PCT levels.
出处
《中国心血管病研究》
CAS
2015年第8期750-753,共4页
Chinese Journal of Cardiovascular Research
关键词
降钙素原
体外循环
心脏术后
细菌感染
诊断
Procalcitonin
Cardiopulmonary bypass
After cardiac surgery
Bacterial infection
Diagnosis
