摘要
目的 探讨血清降钙素原(PCT)和C反应蛋白(CRP)动态水平变化对重型颅脑损伤患者肺部感染的诊断价值。方法 选取2015年1月至2017年12月淮北市人民医院收治的重型颅脑损伤患者60例,根据患者最终是否并发肺部感染分为感染组(n=36例)和未感染组(n=24例),其中感染组经过治疗有21例好转,15例感染持续。分析比较患者入院第一天及确定感染当天、3 d、7 d的PCT和CRP水平差异。结果 ①入院第一天感染组患者PCT水平明显高于未感染组患者(t=5.162 3,P<0.05),CRP水平差异不明显(t=1.197 0,P>0.05),两组患者WBC和NG均处于较高水平,但差异不明显(t=1.333 3、1.872 9,均P>0.05);②确定感染当天好转组与持续组PCT、CRP水平差异不明显(t=–0.696 1、–0.593 4,均P>0.05),感染后3 d、感染后7 d好转组PCT水平均明显低于持续组(t=–7.856 3、–14.558 5,均P<0.05),感染后3 d、感染后7 d好转组CRP水平均明显低于持续组(t=–3.011 4、–18.113 9,均P<0.05);③好转组感染后PCT、CRP水平均呈下降趋势;持续组感染后PCT水平大体呈上升趋势,CRP水平变化不明显;④治疗后,感染好转组WBC和NG水平明显低于感染持续组患者(t=2.670 0、–3.441 5,均P<0.05)。结论 重型颅脑损伤患者治疗过程中动态监测PCT、CRP水平变化有助于进行肺部感染预测、诊断及了解病情进展,早期肺部感染PCT较CRP诊断价值更高。
Objective To investigate the diagnostic value of dynamic changes of serum procalcitonin (PCT) and C-reactive protein (CRP) levels in patients with severe craniocerebral injury.Methods Sixty patients with severe craniocerebral trauma who were admitted to our hospital from January 2015 to December 2017 were selected,and they were divided into infection group (n=36) and non-infection group (n=24) according to whether the patient eventually had pulmonary infection.In the infection group,21 cases were cured and 15 cases were persistent infectious.The differences of PCT and CRP levels between the first day of hospital admission and the day of infection,3d,7d were analyzed and compared.Results ① The PCT level in the infection group was significantly higher than that in the uninfected group on the first day of admission (P<0.05),while there was no significant difference in the CRP level between the two groups (P>0.05),WBC and NG were higher in both groups,but the difference was not significant (t=1.333 3,1.872 9,all P>0.05).②There was no significant difference in PCT and CRP levels between the improvement group and the continuous group on the day of infection (t=-0.696 1,–0.593 4,all P>0.05),the levels of PCT in the improved group was significantly lower than those in the continuous group on the 3d,7d after infection (t=–7.856 3,–14.558 5,all P<0.05),the levels of CRP in the improved group was significantly lower than those in the continuous group on the 3d,7d after infection (t=–3.011 4、–18.113 9,all P<0.05)③The PCT and CRP levels in the improved group showed a decreasing trend.The PCT level in the continuous group increased generally and the CRP level did not change significantly.④ After treatment,the WBC and NG levels in the improved group were significantly lower than those in the continuous group (t=2.670 0,–3.441 5,all P<0.05).Conclusion The dynamic monitoring of PCT and CRP levels during the treatment of severe craniocerebral injury patients is helpful for the prediction of pulmonary infectio
作者
秦丹
王建斌
QIN Dan;WANG Jian-bin(Department of Critical Care Medicine,Huaibei People's Hospital,Huaibei,Anhui 235000)
出处
《临床输血与检验》
CAS
2020年第1期92-96,共5页
Journal of Clinical Transfusion and Laboratory Medicine
关键词
C反应蛋白
降钙素原
肺部感染
颅脑损伤
C-reactive protein
Procalcitonin
Pulmonary infection
Craniocerebral injury
