多发伤患者血浆中PCT含量及对脓毒症的预测价值

Influence of Plasma PCT Levels on Predictive Value of Multiple Trauma with Sepsis

目的监测多发伤患者早期血浆中前降钙素(PCT)的含量,探讨它与多发伤后并发脓毒症之间的关系,评价对多发伤后并发脓毒症的预测价值。方法 50例存在全身炎症综合征的多发伤患者,入住ICU后1h内留取血标本,采用德国Brahms Diagnostica公司生产的LUMItest PCT试剂,应用双抗夹心免疫发光法对血清前降钙素进行半定量检测;根据是否合并感染分为脓毒症组(20例)与非脓毒症组(30例),评价PCT预测多发伤后并发脓毒症的敏感度、特异性。结果 (1)脓毒症组(S组)多发伤患者入ICU时血浆PCT(中位数3.0,范围1.0～4.0)明显高于非脓毒症组(NS组)(中位数1.0,范围1.0～4.0)。(2)PCT对合并脓毒症的多发伤患者诊断的敏感性、特异性、PPV、NPV分别为85.0%(17/20)、80.0%(24/30)、73.9%(17/23)和88.9%(24/27)。结论多发伤患者早期血浆PCT含量明显升高,有并发脓毒症的倾向;PCT可作为多发伤后并发脓毒症的早期预警指标,且其敏感度和特异性较高。

Objective To investigate the serum PCT level in multiple trauma with sepsis and the relationship between PCT and multiple trauma with sepsis in an effort to evaluate the effect of the level on the predictive value in multiple trauma with sepsis.Methods （1）The serum PCT was determined within the first hour after 50 cases of the whole body inflammation syndrome were admitted to ICU.The semi-quantitative detection of the serum procalcitonin concentration was carried out by Double-antibody sandwichimmunoluminometric assay （PCT-Q,BRAHMS Diagnostica,Germany）.Sensitivity, specificity and predictive values of procalcitonin in multiple trauma with sepsis were evaluated.（2）Fifty cases were divided into two groups：Sepsis group （S group, 20cases） and non-sepsis group （NS group, 30 cases） according to whether to complicate infection.Results （1）The serum PCT at admission to ICU was significantly higher in S group（media 3.0,range 1.0-4.0）,compared with NS group（media 1.0,range 1.0-4.0）.（2）Sensitivity,specificity,PPV and NPV to multiple trauma with sepsis were 85.0%（17/20）,80.0%（24/30）,73.9%（17/23）and88.9% （24/27）,respectively.Conclusion The serum PCT level is high early time in multiple trauma with a concurrent sepsis tendency, and the serum PCT can be used as an early warning target of multiple trauma with sepsis, with high sensitivity and specificity.