感染性发热患者检测血清降钙素原、D-二聚体和心肌肌钙蛋白Ⅰ水平的临床意义

Clinical significance of serum procalcitonin and D-dimer and cardiac troponin Ⅰ in acute infectious fever

目的探讨检测血清降钙素原(PCT)、D-二聚体(D-D)、心肌肌钙蛋白I(cTnI)对感染性发热患者出现全身病理改变的临床意义。方法回顾性分析2013年1月-2014年1月以发热收入院治疗的130例感染性发热患者的临床资料。根据临床特征将其分细菌感染组和病毒感染组,其中细菌感染组又分为血流感染组及局灶性感染组的临床资料。分析比较各组血清PCT、D-D及cTnI水平变化。结果细菌感染组与病毒感染组比较,PCT、D-D、cTnI显著增高(P<0.05);血流感染组与局灶感染组比较,PCT、D-D、cTnI增高,差异有统计学意义(P<0.05)。结论血清PCT、D-D和cTnI检测可用于早期感染严重程度的判断,判断是否引起凝血功能异常及心肌细胞受损,为临床早期合理应用抗凝药物提供理论依据。

[Objective] To evaluate the clinical significance of testing serum procalcitonin （PCT） and Ddimer and cardiac troponin I （cTnI） in acute infectious fever. [Methods] A retrospective analysis was made for 130 cases of febrile diseases from January 2013 to January 2014. According to the clinical causes of fever, the cases were divided into infectious fever group and non-infectious group. The infectious group was subdivided into bacterial and viral infectious groups. The bacterial group was subdivided into bloodstream infectious and focal infectious groups. Tests of serum procalcitonin, D-dimer and cardiac troponin I were analyzed and compared between the different groups. [ Results] The serum levels of PCT, D-dimer and cTnI in the bacterial infectious group were statistically higher than those in the viral infectious group （P 〈 0.05）. They were significant higher in the bloodstream infectious group than in the focal infectious group （P 〈 0.05）. [Conclusions ] The serum levels of PCT, D-dimer and cTnI are important sensitive markers for assessment of illness severity in early infection and for estimation of coagulation disorder and damage of myocardial ceils. The markers could provide the theoretic basis for the use of anticoagulation drugs in treating the acute infectious fever patients.