降钙素原在判断糖尿病足感染程度及预后中的价值

Value of procalcitonin in judging diabetic foot infection degree and prognosis

目的比较降钙素原(PCT)、超敏C-反应蛋白(hs-CRP)、白细胞(WBC)和血沉(ESR)在判断糖尿病足(DF)感染中的作用,探讨PCT在判断DF感染程度及预后中的价值,寻找临床中反映DF感染的可靠指标。方法选择2010年1月-2013年1月在医院就诊的83例DF患者为研究对象,将其按照感染程度分为无感染组22例、轻度感染组26例、中度感染组28例和重度感染组7例,比较4组PCT、hs-CRP、WBC和ESR的差异;根据DF预后分为治愈组23例、好转组44例和无效组16例,比较各组中PCT、hs-CRP、WBC和ESR的差异;采用SPSS13.0软件进行数据处理。结果随着感染程度的加重,PCT、hs-CRP、WBC和ESR均逐渐升高,轻度感染组、中度感染组、重度感染组PCT、hs-CRP、WBC、和ESR均显著高于无感染组,差异均有统计学意义(P<0.01);重度感染组PCT、hs-CRP、WBC和ESR均显著高于轻度感染组和中度感染组,差异均有统计学意义(P<0.01);无效组及好转组的PCT(0.75±0.12)、(0.20±0.08)ng/ml和hs-CRP(48.60±4.85)、(22.69±2.36)mg/L均显著高于治愈组的(0.12±0.01)、(6.53±0.65)mg/L,差异均有统计学意义(P<0.01)。结论 PCT是可以反应DF患者感染程度和预后的良好炎症指标。

OBJECTIVE To compare the functions of procalcitonin（PCT）, high sensitivity C reactive protein（hs- CRP）, white blood cell count（WBC） and erythrocyte sedimentation rate（ESR） in judging the diabetic foot（DF） infection, to explore the value of PCT in judging the degree of DF infection and the prognosis, and to look for reli- able indexes which could reflect DF infection in clinical practice. METHODS A total of 83 DF patients who were treated in the hospital from Jan 2010 to Jan 2013 were selected as study subjects and were divided into the non- infection group （22 cases）, mild infection group （26 cases）, moderate infection group （28 cases） and severe infec- tion group（7 cases） as per the infection degree. The differences of PCT, hs-CRP, WBC and ESR were compared among the 4 groups. They were also divided into cured group （23 cases）, improved group （44 cases） and invalid group （16 cases） as per prognosis, and the differences of PCT, hs-CRP, WBC and ESR were compared among the 3 groups. SPSS 13.0 software was adopted for data processing. RESULTS The concentrations of PCT, hs-CRP, WBC and ESR were increased gradually with the aggravation of infection. The concentrations of PCT, hs-CRP, WBC and ESR of non-infection group were significantly lower than that of the mild infection group, moderate infection group and severe infection group （P〈0.01）. The concentrations of PCT, hs-CRP, WBC and ESR of se- vere infection group were all significantly higher than that of the mild infection group and moderate infection group （P〈0.01）. The concentrations of PCT （0. 75±0. 12/0. 20±0.08ng/ml） and hs-CRP （48.60±4.85/22. 69± 2.36 mg/L）of the invalid group and improved group were significantly higher than that （0. 124±0.01/6.53±0.65 mg/L）of the cured group （P〈0.01）. CONCLUSION PCT has important value in judging the degree of infection and the prognosis in DF patients.