降钙素原早期评估细菌感染严重程度的应用研究

目的:探讨血清降钙素原(PCT)在早期评估细菌感染严重程度中的应用价值,并与C反应 蛋白(CRP)、白细胞计数(WBC)及体温进行比较.方法:根据美国胸科医师学会和危重病医学会 会议(ACCP/SCCM)标准及临床表现,将 139例细菌感染患者分为局部感染组(A组)50例、脓毒血 症组(B组)5l例、严重脓毒血症组(C组)21例及脓毒性休克组(D组)17例,选取同期住院但无感染 的患者 20例为对照组.入选患者入院治疗前抽血查PCT、CBP及WBC水平、记录体温,治疗 5天后 复查 PCT水平.结果:PCT水平以 D组最高,为(42.36±48.49)ng/mL,高于其余各感染组(P 均< 0.05).C组PCT(4.66±2.46)ng/mL,高于B组的(1.08±0.68)ng/mL及A组的(0.09±0.05)ng/mL(P均< 0.05).各感染组 PCT水平均高于对照组的(0.05±0.01)ng/mL(P 均<0.05);各组 CRP、WBC水平及 体温比较差异均无统计学意义(P均>O.05).治疗 5天后所有感染组PCT较治疗前均下降,差异有 统计学意义(P<0.01).结论:PCT水平可以早期评估细菌感染的严重程度,有助于监测病情变化.

Application of Serum Procalcitonin for Early Evaluation of Bacterial Infection Severity

Objective:To explore the value of serum procalcitonin(PCT)for early evaluation of the severity in bacterial infection and compare it with C reactive protein(CRP),white blood cell count(WBC),and temperature to understand their strength and weaknesses.Methods: A total of 139 patients with bacterial infection administered in our hospital from July 2009 to June 2010 were divided into 4 groups,including local bacterial infection group(Group A,n=50),sepsis group(Group B,n=51),severe sepsis group(Group C,n=21),and septic shock group(Group D,n=17) according to ACCP/SCCM consensus conference and the clinical manifestations.Twenty noninfectious patients during the same period were recruited as control(Group E,n=20).PCT,CRP,WBC,and temperature were evaluated in all patients before treatment and PCT were measured again 5 days after treatment.Results: During the early period of bacterial infection,PCT was the highest in Group D([42.36±48.49] ng/mL),followed by(4.66±2.46)ng/mL in Group C,(1.08±0.68) ng/mL in Group B,and(0.09±0.05)ng/mL in Group A(P<0.05).PCT in the 4 infectious groups were all higher than that in Group E [(0.05±0.01)ng/mL,P<0.05].No significant difference in CRP,WBC,and temperature was noted among all groups(P>0.05).After 5-day treatment,PCT decreased in the 4 infectious groups than that before treatment(P<0.01).Conclusion: The level of PCT can be used to evaluate the severity of bacterial infection at the early stage.This may be of help for monitoring the patient’s condition.