血清降钙素原对重症颅脑损伤继发感染的诊断价值

Serum procalcitonin level in diagnosis of secondary infection in patients with severe cranio-cerebral injury

目的探讨血清降钙素原(PCT)对重症颅脑损伤继发感染的诊断价值。方法选取重症颅脑损伤继发感染31例(感染组),未继发感染的重症颅脑损伤30例(未感染组),健康体检者30例(对照组);观察三组间血清PCT、白细胞计数(WBC)及C-反应蛋白水平(CRP)。另观察6例重症感染者PCT水平的动态变化与预后的关系。结果入院第1天感染组PCT水平高于未感染组和对照组(P<0.001);感染组C-反应蛋白水平与未感染组之间差异无统计学意义(P>0.05),但都明显高于对照组(P<0.001);感染组与未感染组的WBC水平差异无统计学意义(P>0.05),但都高于对照组(P<0.001)。重症感染的6例中3例PCT水平持续>7.3ng/ml者死亡,3例存活患者随着临床症状的改善PCT水平呈下降趋势。结论 PCT水平与临床感染症状的严重程度密切相关,对诊断重症颅脑损伤继发感染有重要的意义,也可作为判断其预后的参考指标。

Objective To study the serum procalcionin（PCT） level in diagnosis of secondary infection in patients with severe craniocerebral injury.Methods Serum PCT level,white blood cells（WBC） and C-reaction protein（CRP） level were observed in 31 patients with secondary infection of severe craniocerebral injury（infection group）,and 30 patients without secondary infection of severe craniocerebral injury（non-infection group）,and 30 healthy controls（control group）.Relation between dynamic serum PCT level change and prognosis was studied in an additional 6 patients with secondary infection of severe craniocerebral injury.Results The serum PCT level was higher in infection group than in non-infection group and control group on day 1 after admission（P〈0.01）.No significant difference was found in CRP level between infection group and non-infection group（P〈0.05）,but the CRP level was significantly higher in infection group and non-infection group than in control group（P〈0.001）.No significant difference was observed in WBC between infection group and non-infection group（P〈0.05）,but the number of WBC was greater in infection group and non-infection group than in control group（P〈0.01）.Of the 6 patients with secondary infection of severe craniocerebral injury,3 with their serum PCT level 7.3ng/ml died,and 3 survived with their serum PCT level decreased due to the improved clinical symptoms.Conclusion Serum PCT level,which is related with the severity of clinical infection symptoms,plays an important role in diagnosis of secondary infection of severe craniocerebral injury and can also be used as a predictor for the secondary infection in patients with severe brain injury.