摘要
目的探讨降钙素原(PCT)联合C反应蛋白(CRP)在脊柱内固定术后感染早期诊断的临床意义。方法回顾性分析本院2016年1月-2017年6月行脊柱(颈椎、胸椎、腰椎)内固定手术,并在术后出现发热或切口渗液的患者60例,按培养结果,分为感染组(26例)和对照组(34例),记录术前、术后发热或切口渗液时PCT、CRP、红细胞沉降率(ESR)、白细胞计数(WBC)的变化并比较两组间的差异。结果两组术前各项指标间的差异均无统计学意义(P>0.05),两组中各项指标在术后均较术前明显升高,差异有显著性(P<0.05),感染组术后的PCT、CRP高于对照组术后的,差异有显著性(P<0.05),但两组术后ESR、WBC差异无统计学意义(P>0.05)。ROC曲线(受试者工作特征曲线receiver operating characteristic curve)表明,PCT在诊断感染的敏感度及特异度上均好于CRP。结论降钙素原联合C反应蛋白在脊柱内固定术后感染的早期诊断中有重要指导价值。
Objective To explore the clinical significance of procalcitonin（PCT）combined with C reactive protein（CRP）in the early diagnosis of infection after spine surgery with internal fixation.Methods A retrospective analysis 60 patients received the spine（cervical,thoracic and lumbar）surgery with internal fixation and and developed postoperative fever or Incisional exudation in our hospital from January 2016 to June 2017,according to the result of bacterial culture,divided into infection group（26 cases）and control group（34 cases）,the changes of PCT,CRP,erythrocyte sedimentation rate（ESR）and white blood cell count（WBC）were recorded before surgery and after surgery during fever or incisional exudation,and compare the differences between the two groups.Results There was no significant difference between the two groups among the indicators before operation（P〉0.05）.among the indicators after surgery in the two groups were significantly higher than those before surgery,and the difference was significant（P〈0.05）.the PCT and CRP after surgery in the infection group were higher than those of the control group,the difference was significant（P〈0.05）.there was no significant difference in ESR and WBC between the two groups after surgery（P〉0.05）.The ROC curve showed that PCT was more sensibility and specificity than CRP in diagnosis infection.Conclusion PCT combined with CRP has an important guiding value in the early diagnosis of infection after spine surgery with internal fixation.
作者
刘键
陈科
王先安
林明侠
李明东
LIU Jian;CHEN Ke;WANG Xian-an(Spine Surgery, Hainan General Hospital, HaiKou 570311 ,China)
出处
《中国实验诊断学》
2018年第6期952-955,共4页
Chinese Journal of Laboratory Diagnosis
关键词
降钙素原
C反应蛋白
脊柱内固定手术
术后感染
procalcitonin
C reactive protein
spine surgery with internal fixation
postoperative infection
