降钙素原检测对体外循环术后感染早期临床诊断价值

DIAGNOSTIC VALUE OF PROCALCITONIN DETECTION IN EARLY POSTOPERATIVE INFECTION AFTER CARDIOPULMONARY BYPASS

目的探讨降钙素原（PCT）检测在体外循环术后早期感染与非感染全身炎症反应综合征诊断中的应用。方法对行体外循环的106例病人,分别于术前、术后第1~5天采集清晨静脉血行PCT检测,同时行血细菌培养检查。结果 106例病人术前PCT值均〈0.046μg/L。术后血培养阳性者3例,其中肺炎克雷伯菌1例,铜绿假单胞菌1例,金黄色葡萄球菌1例;血培养阴性103例。血培养阴性病人血清PCT均于术后第1天即达峰值,且均〈5.000μg/L,后逐渐下降,第5天恢复正常;血培养阳性病人血清PCT值术后第1天最低为5.250μg/L,后逐渐升高或者维持该水平,最高为7.390μg/L。结论 PCT连续检测可以早期发现体外循环术后感染性全身炎症反应综合征,避免严重感染的发生。

Objective To investigate the application of procalcitonin （PCT） detection in the early diagnosis of infections and noninfectious systemic inflammatory response syndrome after cardiopu/monary bypass （CPB）. Methods PCT was detected （one day before and one to five days after surgery） in 106 patients undergoing CPB. Blood culture was done at the same time. Resuits Before surgery, PCT values were less than 0.046μg/L in all the 106 patients. Postoperative blood culture was identified positive in three cases： Klebsiella pneumoniae, Pseudomonas aeruginosa, and Staphylococcus aureus, one case respectively. Negative blood cultured was recorded in 103 cases. Serum PCT in the patients with negative blood culture reached the peak value the first day after surgery, being less than 5.000μg/L, and then decreased gradually, returned to normal on the fifth day~ that in the patients with positive blood culture, the lowest was 5.250μg/L on the first day after surgery, and elevated gradually or kept at that level, the highest was 7.390μg/L. Conclusion Early discovery of systemic inflammatory response syndrome after cardiopulmonary bypass surgery through continuous detection can avoid the occurrence of severe infection.