重症颅脑损伤患者血清中CRP和PCT水平与急性呼吸衰竭病情的关系

目的:研究重症颅脑损伤患者血清中C-反应蛋白(CRP)和降钙素原(PCT)水平与急性呼吸衰竭病情的关系.方法:选取2015年5月至2016年4月我院收治的77例重症颅脑损伤患者,根据患者实验室检查结果和临床特征分为急性呼吸衰竭病情组(46例)和非急性呼吸衰竭病情组(31例).比较两组研究对象在入院后第1d、3d、5d、7d血清CRP、PCT水平,比较CRP、PCT及两者联合检测的特异性、敏感性、ROC曲线下面积(AUC).结果:两组患者在入院后第1d、3d、5d、7d的血清CRP水平均呈上升趋势,急性呼吸衰竭病情组在入院后第1d、3d、5d、7d的PCT水平呈上升趋势,急性呼吸衰竭病情组的血清CRP、PCT水平在入院后第1d、3d、5d、7d始终高于非急性呼吸衰竭病情组,两组在组间、不同时点间交互效应比较差异有统计学意义(P<0.05).重症颅脑损伤患者使用血清CRP、PCT并联合检测诊断急性呼吸衰竭的特异性为0.773、敏感性为0.817,AUC为0.873,明显高于血清CRP、PCT两项单独检测.结论:重症颅脑损伤患者血清CRP、PCT水平和急性呼吸衰竭病情存在密切关联性,通过联合检测血清CRP、PCT水平能提高重症颅脑损伤患者合并急性呼吸衰竭的诊断价值.

Relationship between Serum CRP and PCT Levels and Acute Respiratory Failure in Patients with Severe Craniocerebral Injury

Objective:To study the relationship between serum C-reactive protein (CRP) and procalcitonin (PCT) levels in patients with severe craniocerebral injury and acute respiratory failure. Methods: From May 2015 to April 2016,77 patients with severe craniocerebral injury were selected. According to the results of laboratory examination and clinical features,the patients were divided into acute respiratory failure group (46 cases) and non-acute respiratory failure group (31cases). The levels of serum CRP and PCT were compared between the two groups at 1d,3d,5d and 7d after admission,and the specificity,sensitivity and area under the ROC curve (AUC) were compared between CRP and PCT. Results: The levels of serum CRP in the two groups were increased at 1d,3d,5d and 7d after admission,the level of PCT in the patients with acute respiratory failure was increased at 1d,3d,5d and 7d after admission,the levels of serum CRP and PCT in the patients with acute respiratory failure were higher than those in the non-acute respiratory failure group at 1d,3d,5d and 7d after admission,there was significant difference between the two groups,between the two groups at different time points (P <0.05). Patients with severe craniocerebral injury using serum CRP,PCT combined detection in parallel and diagnosis of acute respiratory failure specificity of 0.773,the sensitivity was 0.817,and the AUC was 0.873,which was significantly higher than that of serum CRP and PCT alone. Conclusion:The levels of CRP,PCT and acute respiratory failure in patients with severe craniocerebral injury are closely related. The combined detection of serum CRP and PCT can improve the diagnostic value of acute re-spiratory failure in patients with severe craniocerebral injury.