血浆降钙素原在骨折手术部位感染中的诊断价值

Diagnostic Significance of Procalcitonin for Operative Site Infections in Patients with Bone Fracture

目的:揭示骨折手术部位感染患者血浆降钙素原浓度的变化,探讨其对骨折手术部位感染的诊断价值。方法:收集骨折手术部位感染患者18例和非感染患者102例的静脉血,ELISA检测血浆降钙素原浓度,统计分析其对骨折手术部位感染的诊断价值。结果:协方差分析显示,骨折手术部位感染患者血浆降钙素原浓度(3.71.9)μg/L显著高于非感染患者(0.50.1)μg/L(P<0.001)。Logistic回归分析显示,血浆降钙素原浓度(OR=2.425,95%CI=1.846～2.914,P<0.001)是骨折手术部位感染的独立危险因素。ROC曲线分析显示,血浆降钙素原浓度对骨折手术部位感染有显著诊断价值(曲线下面积=0.917,95%CI=0.861～0.964,P<0.001),且判定血浆降钙素原浓度>3.9μg/L,对诊断骨折手术部位感染有88.9%的灵敏性和86.3%的特异性。结论:骨折手术部位感染患者血浆降钙素原浓度显著升高,临床检测该指标可用于诊断骨折手术部位感染,且具有较高的灵敏性和特异性。

Objective To investigate plasma procalcitonin levels in the patients with bone fracture operative site infections and evaluate its diagnostic value for operative site infections.Methods Veneus blood of 18 patients with bone fracture operative site infections and 102 patients without those were collected.Plasma procalcitonin concentration was measured by enzyme-linked immunosorbent assay.Its diagnostic value for operative site infection was analyzed statistically.Results The plasma procalcitonin level（3.7±1.9）μg/L in patients with bone fracture operative site infections was significantly higher than that（0.5±0.1）μg/L in patients without those using analysis of covariance（P0.001）.On a multivariate logistic regression,plasma procalcitonin level（OR=2.425,95%CI=1.846~2.914,P0.001） was an independent variable predicting operative site infection.A receiver operating characteristic curve identified that a plasma procalcitonin level3.9μg/L diagnosed operative site infection with 88.9% sensitivity and 86.3% specificity（area under curve=0.917,95%CI=0.861~0.964,P0.001）.Conclusion Plasma procalcitonin concentration increased after bone fracture operative site infection and diagnosed operative site infection with high sensitivity and specificity.