血清降钙素原在骨折患者术后感染中的诊断价值

目的探讨降钙素原（PCT）、C反应蛋白（CRP）和WBC对骨折患者术后感染的预测价值。方法回顾性分析49例开放性骨折患者的资料，根据术后感染情况分为术后感染组（24例）和无感染组（25例），分别在第1、4、7和第10天检测患者血液中的PCT、CRP和WBC值，并与健康对照组进行比较。应用受试者工作特征（ROC）的曲线下面积分析各指标对术后感染的诊断价值。结果感染组和无感染组术后第1天PCT、CRP和WBC与健康对照组比较，差异有统计学意义（F值分别为19．84、57．71和35．44，P值均〈0．01）。术后第4、7和第10天，感染组的PCT、CRP和WBC值均高于无感染组，且差异有统计学意义（tPCT值分别为7．31、7．74和4．59，tCRP值分别为2．23、5．75和8．01，tWBC值分别为2．34、2．51和4．07，P值均〈0．05）。ROC曲线分析表明，PCT对开放性骨折术后感染诊断的特异性和敏感性均高于CRP和WBC。结论骨折术后并发感染可引起PCT、CRP和WBC的增高，PCT检测的敏感性和特异性较高，对骨折术后感染的早期诊断更具临床价值。

Diagnostic significance of procalcitonin for postoperative infections in patients with bone fractures

Objective To investigate the significance of procalcitonin （PCT）, C-reactive protein （CRP） and WBC counts in predicting the postoperative infections in patients with bone fractures. Methods Clinical data of 49 patients with open fractures were retrospectively analyzed, and the patients were grouped into the infected （n =24） and non-infected （n =25）. PET, CRP and WBC values were detected 1, 4, 7 and 10 days after the operations, and the results were compared with those taken from the healthy controls. Areas under the receiver operating characteristic （ROC） eurves were used to determine the value in predicting postoperative infections. Results PCT, CRP and WBC values in the infected group and the noninfected group were higher than those in health controls （ F = 19.84, 57.71 and 35.44, P 〈0.01 ）. PCT , CRP and WBC values in the infected group were higher than those in the non-infected group 4, 7 and 10 days after the operations （ tPCT = 7, 31 , 7.74 and 4.59 ; tCRP = 2.23,5.75 and 8.01 ; tWBC = 2.34, 2.51 and 4.07, P 〈0.05）. ROC curves suggested that PCT value was more sensitive and had higher specificity than CRP and WBC values in the diagnosis of postoperative infections. Conclusions PCT, CRP and WBC values arise in bone fracture patients with postoperative infections. Detection of PCT has higher sensitivity and specificity, which can be used in early diagnosis of postoperative infections.