摘要
目的探讨脑脊液与血清降钙素原(PCT)检测对术后颅内感染的预测价值,以期为预防颅脑手术后并发感染提供数据参考。方法选取2011年5月-2014年5月在医院接受开颅手术的68例患者为研究对象,其中发生术后感染39例患者作为观察组;未发生术后感染29例患者作为对照组,动态监测脑脊液与血清PCT水平变化,并与脑脊液与血液的常规生化指标作比较分析,数据采用SPSS 19.0软件进行统计分析。结果观察组患者脑脊液与血清PCT及体温水平显著高于对照组,脑脊液葡萄糖水平显著低于对照组(P<0.05);脑脊液葡萄糖及PCT、血清PCT、外周血白细胞、中性粒细胞、体温对颅内感染诊断的敏感度分别为:60.1%、96.0%、68.9%、76.9%、76.1%;特异性分别为:85.4%、61.1%、51.2%、44.9%、43.8%,将脑脊液PCT阳性阈值设为0.08ng/L时,其阳性预测值、阴性预测值、灵敏度及特异度均>90.0%。结论脑脊液PCT与血清PCT检测对术后颅内感染的诊断与预后判断具有重要临床价值。
OBJECTIVE To explore the predictive value of procalcitonin level of serum and cerebrospinal fluid for intraeranial infections after craniotomy, so as to provide reference data for the prevention of concurrent infection.after cranioeerebral operations. METHODS Totally 68 hospitalized patients undergoing craniotomy operation from May 2010 to May 2013 were collected. The diagnosis of intraeranial infection was based on nosoeomial infection diagnostic criteria （trial） issued by the Ministry of Health. A total of 39 cases with postoperative infections were as the observation group, The rest without postoperative infection were as the control group （29 cases）. The procal- citonin levels Of serum and cerebrospinal fluid of two groups were dynamically monitored and compared. SPSS 19.0 was explored for statistical analysis. RESULTS The proealcitonin level of serum and cerebrospinal fluid as well as body temperature of the observation group were significantly higher than the control group. Glucose level of cerebrospinal fluid was significantly lower than the control group （P〈0.05）. ROC indicated that sensitivity of procalcitonin level of serum and cerebrospinal fluid, glucose level of cerebrospinal fluid, neutrophil percentage, peripheral white blood cells and body temperature were 60.1 %, 96.0 %, 68.9 %, 76.9 %, and 76.1%. The specificity were 85.4%, 61. 1%, 51.2%, 44.9%, and 43.8% respectively. The positive predictive value, negative predictive value, sensitivity and specificity of proealcitonin level of cerebrospinal fluid were all greater than 90% when positive threshold was set as 0.08 ng/L. CONCLUSION The procalcitonin levels of serum and cerebrospinal fluid have great clinical value in diagnosis and prognosis of intracranial infection after craniotomy.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2015年第24期5612-5614,共3页
Chinese Journal of Nosocomiology
基金
湖北省自然科学基金资助项目(2011CDB493)
关键词
颅内感染
降钙素原
脑脊液
血清
Intracranial infection
Procalcitionin
Cerebrospinal fluid
Serum
