多发伤患者外周血降钙素原及C反应蛋白的动态变化及意义

Dynamic change of peripheral blood procalcitonin and C reactive protein and their clinical significame in patients with multiple injury

目的 探讨多发伤患者外周血降钙素原（procalcitonin，PCT）与C反应蛋白（C reacfive protein，CRP）的动态变化及其临床意义。方法 将96例多发伤患者按照ISS、输血量的多少、有无MODS、感染、脓毒血症及预后情况进行分类，分别检测不同类别患者外周血PCT、CRP浓度。结果 与对照组相比，多发伤患者PCT和CRP均明显升高，其峰值分别出现在伤后2d（PCT），5，7d（CRP）。发生MODS、感染及脓毒血症时，PCT和CRP均明显升高。此外，PCT还与患者ISS评分、预后和输血量具有相关性。结论 联合检测PCT、CRP有助于多发伤患者伤情的诊治及预后判断，其中PCT较CRP更具有敏感性。

Objective To investigate the dynamic change of peripheral blood procalcitonin and C reactive protein and their clinical significance in patients with multiple injury. Methods According to injury severity score （ ISS ）, blood transfusion volume, prognosis, MODS （ or not）, infection, pyemia and prognosis, 96 patients with multiple injury were classified to detect the concentrations of PCT and CRP in peripheral blood of all samples. Results Compared with control group, the multiple injury group showed significant higher concentrations of PCT and CRP, with peak value at day 2 after injury （PCT） and at days 5 and 7 after injury （CRP）. PCT and CRP rised up obviously under MODS, infection and pyemia. The concentration of PCT was related with injury severity, prognosis and blood transfusion volume. Conclusion Combined detection of PCT and CRP is helpful for diagnosis, treatment and prognosis evaluation of multiple injury patients, when PCT shows higher sensitivity than CRP.