血清降钙素原对骨折术后感染的诊断价值

The diagnostic value of procalcitonin for postoperative infection in patients with bone fracture

目的探讨在骨折术后感染中血清降钙素原(PCT)水平检测的诊断价值。方法 2008年9月至2011年9月骨折术后感染患者30例为感染组,同期未发生感染者30例为非感染组。检测2组血清PCT和C-反应蛋白(CRP)的水平,对比两指标在诊断骨折术后感染诊断中的敏感度和特异度。结果 PCT水平在感染组明显高于非感染组〔(8.68±2.73)vs(0.18±0.09)ng/ml,P<0.01〕。PCT和CRP对骨折术后并发感染诊断的敏感度分别是93.3%、100.0%,特异度分别是90.0%、10.0%,阳性预测值分别为90.3%、52.6%,阴性预测值分别为93.1%、100.0%。PCT对骨折术后并发感染的特异度和阳性预测值高于CRP(P均<0.01)。结论 PCT可用于诊断骨折术后感染,不易受创伤及手术因素干扰,具有较高敏感度和特异度。

Objective To explore the diagnostic value of serum procalcitonin（PCT） for postoperative infection in pa- tients with bone fracture. Methods Eligible 30 patients with bone fracture complicated postoperative infection from September 2008 to September 2011 were served as infection group, and 30 cases without complications of postoperative infection in the same time were selected as no-infection group. The levels of serum PCT and C-reactive protein （CRP） was measured, and their sensibility and specificity for diagnosing postoperative infection in patients with bone fracture were compared. Results PCT level in infection group was significantly higher than that in no-infection group [ （8.68 ±2.73 ） vs （0.18± 0.09） ng/ml, P 〈 0.01]. The sensibilities of PCT and CRP for diagnosing postoperative infection of patients with bone fracture were 93.3% and 100.0% respectively, and the specificities were 90.0% and 10.0% respectively. The positive predictive values of PCT and CRP for diagnosing postoperative infection of patients with bone fracture were 90.3% and 52.6% respectively, and their negative predictive values were 93.1% and 100.0%, respectively. The specificity and the positive predictive value of PCT for diagnosing postoperative infection of patients with bone fracture were obviously better than those of CRP （all P 〈 0.01 ）, Con- clusions PCT can be used in diagnosing postoperative infection of fracture,because it is not influenced by wound and opera- tive factors and has higher sensibility and specificity.