严重多发伤患者血清降钙素原与ARDS关系研究

Relationship between procalcitonin and ARDS in patients with severe multiple trauma

目的研究多发伤患者血清降钙素原的变化,并探讨其与损伤严重度、感染及急性呼吸窘迫综合征(ARDS)的关系。方法测定33例多发伤患者伤后第1、3、7天血清降钙素原水平,同时评定ISS值、急性生理学和既往健康评分(APACHEⅡ),并记录感染、ARDS情况。结果伤后24小时内多发伤患者血清降钙素原水平显著高于对照组(P<0.01),降钙素原水平与APACHEⅡ计分正相关(rs=0.601,P<0.05),发生ARDS者降钙素原及APACHEⅡ值均明显高于脏器功能正常组(P<0.05);发生感染后,降钙素原值显著高于感染前(P<0.05)。结论多发伤可引起降钙素原升高,检测降钙素原变化有助于及早发现感染,并可预警ARDS的发生。

Objective To study the change of serum procalcitonin in patients with multiple trauma,and determine its relationship with the severity of trauma infection and ARDS. Methods The levels of serum procalcitonin was detected 1,3,7d after trauma in 33 cases respectively. The values of ISS, APACHEⅡ were also determined. Meanwhile, the incidence of infection and ARDS were recorded. Results The level of serum procalcitonin in patients with multiple trauma 24h after injury was much higher than that of normal controls （P 〈 0.01 ）, and was positively correlated with APACHEⅡ （ rs=0.601 ,P 〈0.05 ）. The level of serum procalcitonin and the values of APACHEⅡ in patients with ARDS was much higher than that of normal organ function group（P 〈0.05）. Conclusion Serum procalcitonin might increase in patients with trauma,which is positively correlated with the severity of trauma. Dynamic measurement of procalcitonin may help to discover the infection earlier. Procalcitonin is a parameter warning of ARDS.