全身炎症反应综合征评分及血清降钙素原对绞窄性肠梗阻的诊断及意义

The diagnosis and significance of systemic inflammatory response syndrome score and procalcitonin in strangulated intestinal obstruction

目的探讨全身炎症反应综合征评分(SIRS)及血清降钙素原(PCT)对绞窄性肠梗阻的诊断及意义。方法回顾性分析湖北省荆门市第一人民医院胃肠外科2009年1月-2013年1月收治的行手术治疗的126例肠梗阻患者的临床资料,其中绞窄性肠梗阻(绞窄组)86例,非绞窄性肠梗阻(非绞窄组)40例。比较两组患者SIRS评分和PCT的检测结果及这两种指标诊断的特异性、敏感性、阳性预测值和阴性预测值。结果绞窄组SIR评分≥2分及PCT高于正常值的患者例数明显高于非绞窄组,差异具有统计学意义(P<0.001);并且PCT的平均检测值亦明显高于非绞窄组,差异具有统计学意义(P<0.001)。PCT>0.05 ng/ml作为诊断指标时,特异性、敏感性、阳性预测值、阴性预测值均明显高于SIRS评分≥2分(P<0.05)。结论 SIRS评分及PCT检测有助于绞窄性肠梗阻的诊断,但是PCT检测优于SIRS评分。

Objective To investigate the diagnosis and significance of systemic inflammatory response syndrome score （SIRS） and procalcitonin in strangulated intestinal obstruction.Methods The clinical data of 126 patients with strangulated intestinal obstruction undergoing surgery from Jan.2009 to Jan.2013 were reviewed.They were divided into the strangulated group of 86 cases and the non-strangulated group of 40 cases.The SIRS score and PCT were compared.Meanwhile,the specificity,sensitivity,positive and negative predictive value of SIRS ≥ 2 and PCT ＞ 0.05 ng/ml were compared.Results In the strangulated group,the number of SIRS≥2,the number of PCT ＞ 0.05 ng/ml and the average concentration of PCT were higher than those in the non-strangulated group （P ＜ 0.001）.There were significant differences in the specificity,sensitivity,negative and positive predictive value between two diagnostic indexes （P ＜0.05）.Conclusion The SIRS score and PCT are helpful to the diagnosis of strangulated intestinal obstruction,but PCT is superior to the SIRS score.