降钙素原在诊断骨科内置物术后感染性发热的临床意义

Clinical Significance of Procalcitonin in Diagnosis of Infective Fever after Implant Surgery in the Department of Orthopedics

目的探讨降钙素原(proealeitonin,PCT)在诊断骨科内置物术后感染性发热中的临床意义。方法选择2013年1月—2014年1月我院骨科内置物术后发热患者56例,按诊断标准分为非感染发热组32例和感染发热组24例,均于术后发热当天及发热第3天采血查C反应蛋白(CRP)及PCT水平,并对CRP及PCT诊断术后感染性发热的真实性进行评价。结果两组发热当天和发热第3天CRP水平比较差异均无统计学意义(P>0.05),而PCT水平比较差异均有统计学意义(P<0.05)。以0.25 ng/L为临界值,发热当天及发热第3天血清PCT诊断术后感染性发热的敏感度、特异度均较CRP高。结论 PCT在鉴别骨科内置物术后发热性质方面较CPR更具有临床价值。

Objective To investigate clinical significance of procalcitonin （ PCT） in diagnosis of infectious fever after implant surgery in the Department of Orthopedics. Methods From January 2013 to January 2014, a total of 56 patients in Department of Orthopedics had a fever after the implant operation, according to the diagnostic criteria, they were divided into non-infective fever group （n=32） and infective fever group （n=24） and were checked for C-reactive protein （CRP） and PCT on the fever day and the third day. All the results were analyzed, and then the authenticity of diagnosis of postoperative infective fever by CRP and PCT was evaluated. Results There were no significant differences of CRP levels on the fever day and on the third day between the two groups （P〉0. 05）, but PCT levels showed significant differences （P〈0. 05）. The sensitivity and specificity of serum PCT at the level of 0. 25 ng/L as critical value in the diagnosis of postoperative infective fever were higher than those of CRP on the fever day and the third day. Conclusion PCT has more clinical value than CRP in the differential diagnosis of fever after implant surgery in the Department of Orthopedics.