血清降钙素原与C反应蛋白在骨伤感染中的应用

The Significance of Procalcitonin and C-reactive Protein in Diagnosis Infection of Orthopedic Trauma

目的:评价血清降钙素原(PCT)与C反应蛋白(CRP)对骨伤感染的诊断价值。方法:137例骨伤患者分为细菌感染组(72例)和非细菌感染组(65例),另选取30例健康体检者作为正常对照组。采用一步免疫夹心法和最终荧光检测相结合测定血清PCT水平,采用免疫散射比浊法检测血清CRP水平。比较以上各组及细菌感染组感染控制后(细菌感染控制组)血清PCT、CRP的差异。结果:细菌感染组血清PCT水平明显高于非细菌感染组(P<0.01),但细菌感染组血清CRP水平与非感染组比较无统计学差异(P>0.05)。细菌感染组和非感染组血清PCT和CRP水平均高于正常对照组(P<0.01)。细菌感染控制组血清PCT和CRP水平较细菌感染组显著下降(P<0.01),与正常对照组水平接近。以2ng/ml为PCT诊断细菌感染分界点,其灵敏度、特异度分别为84.50%和88.70%,显著高于CRP(P<0.05)。结论:血清PCT、CRP水平检测对骨伤感染的诊断及疗效监测有重要临床意义。

Objective: To evaluate the diagnostic value of serum procalcitonin (PCT) and C-reactive protein(CRP) in orthopedic trauma infection. Method: 137 patients who were suffered orthopedic trauma were enrolled and divided into two groups: infected group(n=72) and non-infected group(n=65). Selection of 30 cases of physical examination as normal control group. Serum PCT was detected by immune sandwich assay and eventually fluorescence method. Serum CRP was tested by immune nephelometry. Results: The concentration of serum PCT in infected group was higher than that in non-infected group and infection control group(P<0.01). There were no statistically significant differences on concentration of serum CRP between infected group and non-infected group. Serum PCT and CRP in infected group and non-infected group were increased than control group(P<0.01). With 2 ng/ml diagnosis boundary for infection, the sensitivity and specificity of PCT was 84.50%, 88.70%, which were higher than CRP(P<0.05). Conclusion: Detection of serum PCT and CRP was significant clinical significance to the diagnosis and survey of curative effect for orthopedic trauma infection.