糖尿病酮症酸中毒患者PCT、CRP、乳酸水平与感染关系

目的探讨糖尿病酮症酸中毒(DKA)患者降钙素原(PCT)、C-反应蛋白(CRP)及乳酸水平变化与感染关系。方法选择2017年1月至2020年7月本院收治的92例DKA患者设为研究组,根据是否合并感染另分两个亚组:将DKA合并感染者设为A组(n=54),将DKA未合并感染者设为B组(n=38),同时纳入98例同期本院接受健康体检结果正常者设为对照组。比较各组PCT、CRP及乳酸水平,绘制ROC曲线分析PCT、CRP、乳酸水平对DKA患者发生感染的预测价值。结果研究组患者PCT、CRP、乳酸水平显著高于对照组,差异有统计学意义(P<0.05)。A组患者WBC、PCT、CRP、乳酸水平明显高于B组,差异有统计学意义(P<0.05)。PCT、CRP、乳酸水平升高与DKA合并感染密切相关(P<0.05)。PCT、CRP、乳酸水平及三者联合曲线下面积分别为0.738、0.855、0.829、0.950,各指标曲线下面积以联合检测最高。结论 PCT、CRP、乳酸水平与DKA合并感染关系密切,监测三者水平变化程度对评估感染病情严重程度具有重要意义。

Study on relationship between PCT,CRP,lactic acid levels and infection in patients with diabetic ketoacidosis

Objective To explore the relationship between the changes in the levels of procalcitonin(PCT),C-reactive protein(CRP)and lactic acid and the infection in patients with diabetic ketoacidosis(DKA). Methods 92 patients with DKA admitted to this hospitol from January 2017 to July 2020 were selected as the study group. Then according to whether the patients were infected or not,they were divided into two subgroups. The patients with DKA combined with infection were set as group A(n=54),and DKA patients without infection were set as group B(n=38). At the same time,98 cases who went to the hospital for a checkup and had normal results were selected as the control group. The levels of PCT,CRP and lactic acid in three groups were compared. The ROC curve was drawn to analyze the predictive value of PCT,CRP,and lactate levels in the occurrence of infection in DKA patients. Results The levels of PCT,CRP,and lactic acid in the study group were significantly higher than those in the control group,and the difference was statistically significant(P<0.05). The levels of WBC,PCT,CRP,and lactic acid in group A were significantly higher than those in group B,and the difference was statistically significant(P<0.05). Increased levels of PCT,CRP,and lactic acid are closely related to DKA co-infection(P<0.05). PCT,CRP,lactic acid levels and the area under the three combined curves were 0.738,0.855,0.829,0.950,respectively,and the area under the three combined curve was the highest. Conclusion PCT,CRP,lactic acid levels are closely related to DKA co-infection,and monitoring the level of changes in the three is of great significance to assess the severity of infection.