劳力性热射病患者血清降钙素原血培养的变化及其临床意义

Change and clinical significance of procalcitonin and blood culture in exertional heatstroke patients

目的探讨劳力性热射病（EHS）患者血清降钙素原（PCT）、血培养的变化及其临床意义。方法采取前瞻性研究方法，收集劳力性热射病患者34例，同时随机收集同期在ICU住院的32例伴有高热的脓毒症（sepsis）患者，比较两组患者血清PCT水平及血培养阳性率。结果热射病组血清PCT水平与伴有高热的脓毒症组患者比较差异有统计学意义（P〈0．05），热射病组血培养阳性率高于伴有高热的脓毒症组患者，但差异无统计学意义（P〉0．05）；同样，EHS患者中血培养阳性组血清PCT水平高于血培养阴性组，但差异无统计学意义（P〉0．05）。结论劳力性热射病患者即使没有细菌感染存在，血清PCT依然可被诱导释放。在血清PCT水平明显升高或血培养阳性患者中，即使找不到细菌感染的直接病灶，也应该使用抗菌药物。

Objective To investigate the change and clinical significance of procalcitonin and blood culture in exertional heatstroke patients. Methods We adopted a prospective study. We collected 34 cases of exertional heatstroke and collected 32 cases of sepsis patients with high fever hospitalized in ICU in the same period. T - test was used to compare the difference of serum PCT levels between twogroups. χ2 - test was used to compare the difference of positive rate of blood culture between two gropes. Results The difference of serum PCT levels between two groups was obviously significant （ P 〈 0.05 ）. The positive rate of blood culture in exertional heatstroke patients was higher than that in sepsis patients with high fever, but the difference was not statistically significant （P 〉 O. 05）. The serum PCT levels of exertional heatstroke patients with positive blood culture was higher than that with negative blood culture, but the difference was not statistically significant （ P 〉 0. 05 ）. Conclusion PCT can be induced to release in exertional heatstroke patients even absence of bacterial infection. Exertional heatstroke patients with higher serum PCT level or positive blood culture should use antibacterials, even if we can＇t find original lesions of bacterial infection.