降钙素原在急性创伤性脊髓损伤患者术后感染早期诊断的应用

目的评价降钙素原﹙PCT﹚在急性创伤性脊髓损伤患者术后感染的早期诊断价值。方法前瞻性地收集216名急性创伤性脊髓损伤患者术前及术后48小时的PCT、CRP、WBC、ESR测定值。比较这些指标在发生术后感染者与未发生术后感染者间的差异。结果 22名患者发生术后感染,发病率为10.2%。手术前各实验室指标在感染者与未感染者间差异无统计学意义。手术后48小时各实验室指标中感染者PCT﹙=6.690,=0.000﹚、CRP﹙=3.024,=0.003﹚高于非感染者。ROC曲线结果表明,PCT﹙AUC=0.825﹚对于术后感染的诊断效果优于CRP﹙AUC=0.685﹚,PCT最佳临界点为0.6ng/ml。结论 PCT在急性创伤性脊髓损伤患者术后感染的诊断取得了较好效果,能够在感染早期及时发现感染并指导临床治疗。

Procalcitonin as an indicator in diagnosis of postoperative infectious complications in patients with acute traumatic spinal cord injury

Objective To evaluate the effectiveness of procalcitonin﹙PCT﹚ in early diagnosis of postoperative infectious complications in patients with acute traumatic spinal cord injury.Methods Clinical data on 216 patients with acute traumatic spinal cord injury were perspectively collected,which included determination of PCT,CRP,WBC,and ESR preoperatively and 48 hours postoperatively.Then,we compared these laboratoryindicators between patients with and without postoperative infections.Results 22 participants developed postoperative infections,with the incidence rate of 10.2%.There were no significant differences between preoperative laboratory tests.At 48 hours after surgery,PCT ﹙t=6.690,P=0.000﹚ and CRP ﹙t=3.024,P=0.003﹚ were significantly higher in infected patients than in those non-infected patients.Result of ROC showed that the effectiveness of PCT was superior to CRP in diagnosing postoperative infections.The best cut-off of PCT was 0.6ng/ml.Conclusions PCT is a reliable indicator in diagnosis of postoperative infection in patients with acute traumatic spinal cord injury,which can detect infection timely and guide treat strategy.