降钙素原与血清C-反应蛋白联合测定对严重多发伤患者早期细菌感染的诊断价值

Procalcitonin and C-reactive protein in diagnosis of early bacterial infection in severe multiple injury patients

目的探讨降钙素原(PCT)与血清C-反应蛋白(CRP)联合测定对严重多发伤患者早期细菌感染的诊断价值。方法应用双抗夹心免疫发光法测定血浆PCT含量,散射比浊法测定血浆CRP水平,对51例ISS≥16分的发生细菌感染的多发伤患者(感染组)伤后,30例健康志愿者(对照组)和46例伤后早期未并发感染的多发伤患者(未感染组)分别进行血浆PCT和CRP水平的测定。结果对照组PCT和CRP值分别为(0.80±0.19)ng/mL和(1.10±0.31)mg/L;感染组PCT和CRP值分别为(35.25±14.61)ng/mL和(46.86±18.59)mg/L,均较对照组明显升高(P<0.01);未感染组PCT值为(1.35±0.33)ng/mL,与对照组比较,差异无统计学意义(P>0.05),与感染组比较,差异有统计学意义(P<0.01);未感染组CRP值为(41.29±16.30)mg/L,与对照组比较,差异有统计学意义(P<0.01),与感染组比较,差异无统计学意义(P>0.05)。结论血浆PCT与CRP联合测定可为严重多发伤患者早期细菌感染提供更准确的诊断依据。

Objective To evaluate the clinical significance of concurrent determination of serum procalcitonin（PCT） and C-reactive protein（CRP） in the diagnosis of early bacterial infection in the severe multiple injury patients. Methods PCT was determined by immunoluminometric assay（ILMA） and CRP was measured by nephelometry. The patients were separated into 2 groups：infec tion group（ISS≥16 scores, 51 severe multiple injury patients）, non-infection group（46 severe multiple injury patients）. Thirty healthy volunteers were as the control group. Results The serum level of PCT and CRP in the infection group was（35.25＋ 14.61） ng/mL and（46.86＋18.59）mg/L respectively, which were much higher than those in the control group（0.80＋0. 19）ng/mL and （1.10＋0.31）mg/L respectively. The serum PCT level in the non-infection group was（1.35＋0.33）ng/mL. There was not statistical difference between control group and non-infection group（P〉0.05） ,and there was statistic difference between the non-infection group and infection group（P〈0. 005）. The serum level of CRP in non-infection group was（41.29＋ 16.30）mg/L. There was statistic difference between the control group and non-infection group（P〈0. 005）, and there was not statistical difference between the non-infection group and infection group（P〉0.05）. Conclusion Concurrent determination of serum PCT and CRP could provide more accurate diagnostic evidence for early bacterial infection in the severe multiple injury patients.