降钙素原在鉴别感染性和非感染性全身炎症反应综合征中的意义

Clinical Significance of Serum Procalcitonin in Differential Diagnose Between Infectious and Non-infectious Systemic Inflammatory Response Syndrome

目的 :评价血清降钙素原 (PCT)对感染和非感染原因引起的全身炎症反应综合征(SIRS)的鉴别作用。方法 :2 2例全身感染性SIRS和 2 5例非感染性SIRS患者入选。在临床出现炎症表现 2 4h内测定血清PCT、白介素 6 (IL 6 )和C 反应蛋白 (CRP)水平。同时记录最高体温、白细胞计数、中性粒细胞比例及血小板计数。结果 :感染性SIRS组患者血清PCT(3.4± 2 .3μg/L)、IL 6 (790± 4 5 6ng/L)及最高体温 (38.7± 1.2℃ )明显高于非感染性SIRS组患者 (分别为 0 .5±1.2 μg/L ,2 6 3± 184ng/L ,38.0± 1.1℃ )。所有炎症指标中 ,PCT和IL 6鉴别感染性和非感染性SIRS的特异性 (分别为 80 %、80 % )和敏感性 (分别为 76 %、70 % )最高。结论

Objective: To evaluate the efficacy of serum Procalcitonin (PCT) in differentiating infectious and non- infectious systemic inflammatory response syndrome (SIRS). Methods: Twenty-two cases of infectious and 25 cases of non-infectious SIRS were enrolled in the study. The serum PCT, interleukin-6 (IL-6), and C-reactive protein(CRP) were determined within 24 hours after clinical onset of SIRS, maximal body temperature, white blood cells count, percentage of neutrophils, and platelet count were also recorded. Results: The levels of serum PCT ((3.4)±(2.3))μg/L, IL-6 (790±456)μg/L, and maximal body temperature ((38.7)±(1.2))℃ in infectious group were significantly higher than that of non-infectious SIRS group ((0.5)±(1.2) μg/L, 263±184 ng/L, (38.0)±(1.1℃)) respectively. PCT and IL-6 showed the highest specificity (≥80%) and the highest sensitivity (≥70%) among all conventional inflammatory indices. Conclusion: PCT might be an effective and valuable indicator to differentiate infectious from non-infectious SIRS.