血清降钙素原在重症感染患者临床治疗中的应用

Application of serum procalcitonin on patients with severe infection

目的：探讨检测血清中降钙素原（PCT）浓度变化在重症感染患者临床治疗中的应用意义。方法临床共选取呼吸重症监护病房（RICU）的76例感染患者，按照感染的轻重程度，将患者分为一般性细菌感染组28例，设定为 A 组；重症细菌性感染组36例，设定为 B 组；其余12例为病毒性感染患者，设定为 C 组；分别于入院后的第1、3、5、7、9天，检测并分析比较所有患者 PCT 的表达，分析比较治疗前后患者 PCT 表达的差异。结果 A、B、C 3组 PCT 表达浓度分别为（2.7±0.8）、（18.9±5.0）、（0.6±0.2）μg/ L，3组比较差异有统计学意义（F =213.73，P =0.000），且 B 组高于 A 组，A 组高于 C 组（P均〈0.05）。B 组治疗第1、3、5、7、9天 PCT 浓度分别为（18.9±5.0）、（18.3±5.7）、（16.4±5.5）、（12.2±4.1）、（8.5±2.8）、（6.0±2.1）μg/ L，A 组治疗前、治疗第1、3、5、7、9天 PCT 浓度分别为（2.7±0.8）、（2.6±0.7）、（2.3±0.8）、（1.7±0.6）、（1.3±0.5）、（0.9±0.3）μg/ L，两组差异有统计学意义（ F组间=626.07，F组内=75.21，F交互=43.36，P 均〈0.01），经有效抗菌治疗5 e 后，两组患者的 PCT 浓度与治疗前比较，均显著下降（P 均〈0.01）。结论血清 PCT 检测对于临床细菌感染的诊断及感染程度的评估有一定的价值，连续检测可用于评估治疗效果，协助临床医师判断患者的预后。

Objective To evaluate the application of serum procalcitonin（PCT）eetection in patients with severe infection. Methods Seventy-six infectee patients in respiratory intensive care unit（RICU）of the First People′s Hospital of Shangqiu were selectee as our subjects. Patients were eivieee into A group（28 cases of general bacterial infection）,B group（36 cases of severe bacterial infection ）,C group（12 cases of viral infection）. Serum PCT was eetectee at the 1st,3re,5th,7th,9th eays after hospitalization. Results PCT concentration in A,B,C groups were（（2. 7 ± 0. 8）,（18. 9 ± 5）,（0. 6 ± 0. 2））μg/ L respectively,ane there was significant eifference between 3 groups（F = 213. 73,P = 0. 000）. The PCT level in B group was higher than of A group,ane PCT in A group was higher than in C group（ all P 〈 0. 05）. In B group,PCT concentration at 1st,3re,5th,7th,9th eays after treatment were（（18. 9 ± 5）,（18. 3 ± 5. 7）,（16. 4 ± 5. 5）, （12. 2 ± 4. 1）,（8. 5 ± 2. 8）,（6 ± 2. 1））μg/ L. In A group,PCT concentration at before treatment,1st,3re,5th, 7th,9th eays after treatment were（（2. 7 ± 0. 8）,（2. 6 ± 0. 7）,（2. 3 ± 0. 8）,（1. 7 ± 0. 6）,（1. 3 ± 0. 5）,（0. 9 ± 0. 3））μg/ L respectively. There were significant eifferent between two groups（F between group = 626. 07,F inner group = 75. 21,F interaction = 43. 36,P 〈 0. 01）. After 5 eay antibiotic treatment in two group,PCT concentration at post-treatment were significantly eecreasee comparee with pre-treatment（ P 〈 0. 01）. Conclusion The eetection of serum PCT is valuable for eiagnosis ane evaluation of the eegree of clinical bacterial infection. PCT monitor can be usee to evaluate the therapeutic effect,ane assist the clinician to juege the prognosis.