全身炎症反应综合征评分及血清CRP、PCT与骨科创伤患者感染的关系分析

Analysis on relationship between systemic inflammatory response syndrome score,serum CRP,PCTand infection in patients with orthopedic trauma

目的探讨全身炎症反应综合征评分及血清C反应蛋白(CRP)、降钙素原(PCT)与骨科创伤患者感染的关系。方法选取2013年6月～2017年6月于我院接受治疗的68例骨科创伤患者为研究对象,按照患者是否出现感染分为感染组(n=20)和未感染组(n=48),按患者预后情况分为预后良好组(n=62)和死亡组(n=6)。抽取患者外周血并检测血清CRP、PCT指标水平,评价患者全身炎症反应综合征评分。结果 68例骨科创伤患者中共发现20例感染患者,感染率为29.41%;感染组血清CRP为(46.58±19.65)mg/L,PCT为(0.56±0.12)ng/mL,全身炎症反应综合征评分为(3.42±1.03)分,明显高于未感染组血清CRP(24.07±4.13)mg/L,PCT(0.21±0.05)ng/mL,全身炎症反应综合征评分(2.10±0.84)分,差异有统计学意义(P <0.05)。本研究随访期间6例患者死亡,死亡率8.82%;死亡组血清CRP为(41.38±13.52)mg/L,PCT为(0.39±0.19)ng/mL,全身炎症反应综合征评分为(3.52±1.27)分,明显高于预后良好组血清CRP(26.87±5.24)mg/L,PCT(0.24±0.08)ng/mL,全身炎症反应综合征评分(2.46±0.68)分,差异有统计学意义(P <0.05)。结论全身炎症反应综合征评分、血清CRP、PCT指标水平在骨科创伤感染患者中变化明显,可作为患者是否并发感染的观察指标,且上述指标能够在一定程度上判断骨科创伤患者的预后情况。

Objective To explore the relationship between systemic inflammatory response syndrome score, serum C-reactive protein(CRP), procalcitonin(PCT) and infection in patients with orthopedic trauma. Methods 68 patients with orthopedic trauma who were treated in our hospital from June 2013 to June 2017 were selected as research objects.According to whether the patients were infected,they were divided into infected group(n=20) and uninfected group(n=48).Patients were divided into good prognosis group(n=62) and death group(n=6) according to their prognosis.Peripheral blood of patients was taken and serum CRP and PCT levels were measured to evaluate the systemic inflammatory response syndrome score. Results In 68 patients with orthopedic trauma,20 infected patients were found, and the infection rate was 29.41%.Among the infected patients,11 patients had respiratory infection accounting for 55.00%,2 patients had blood system infection accounting for 10.00%,5 patients had urinary system infection accounting for 25.00%,1 patient had skin infection accounting for 5.00% and 1 patient had other infections accounting for 5.00%.The serum CRP,PCT and systemic inflammatory response syndrome score of the infected group were respectively(46.58±19.65)mg/L,(0.56±0.12) ng/mL and(3.42±1.03) points,which were significantly higher than(24.07±4.13) mg/L,(0.21±0.05) ng/mL and(2.10±0.84)points of the uninfected group.The data were statistically significant(P < 0.05). During the follow-up period of this study,6 patients died and the mortality rate was 8.82%.The serum CRP,PCT and systemic inflammatory response syndrome score of the death group were respectively(41.38±13.52) mg/L,(0.39±0.19) ng/mL and(3.52±1.27) points, which were significantly higher than(26.87±5.24) mg/L,(0.24±0.08) ng/mL and(2.46±0.68) points of the good prognosis group.The data were statistically significant(P < 0.05). Conclusion The systemic inflammatory response syndrome score, serum CRP,and PCT index levels are significantly changed in patients with orthopedic traumatic infection,which can be used as an observational indicator of whether patients are complicated with infection.In addition, the above indexes can determine the prognosis of patients with orthopedic trauma to a certain extent.