血清降钙素原和人C反应蛋白对泌尿微创术后感染的联合诊断意义

Diagnosis significance of C-reactive protein and serum procalcitonin for urological minimally invasive postoperative infection

目的探讨血清降钙素原(PCT)和人C反应蛋白(CRP)对泌尿微创术后患者不同程度感染的诊断学意义。方法回顾性分析我院收治的150例行泌尿微创术患者测定其白细胞、人CRP和血清降钙素水平,并随访观察其术后感染发生情况,按感染程度分为感染未发组、轻度感染组和重度感染组,分析比较各组间人CRP与血清降钙素水平差异,并分析其浓度水平与感染发生的相关关系。结果重症感染组患者PCT值明显高于轻度感染组及感染未发组,3组间PCT、白细胞、CRP值差异有统计学意义(P<0.01);合并不同感染类型PCT、白细胞、CRP值比较差异具有统计学意义,且合并细菌感染其均值明显高于合并病毒及支原体、衣原体感染;各组3项指标阳性率比较,轻度感染CRP阳性率可达98%,重度感染2项指标阳性率可达100%。结论同时测定血CRP和PCT有助于提高细菌感染性疾病早期判断的特异性,对抗菌药物应用有一定的参考价值。重症感染时,PCT可作为预测感染的重要依据;局部或轻度感染时,PCT一般轻度升高,而CRP升高相对明显,在没有全身表现的感染时,CRP可能是一个重要的观察指标。

Objective To investigate C-reactive protein（CRP）and serum procalcitonin in patients with urological minimally invasive surgery to varying degrees the diagnostic significance of infection. Methods A retrospective analysis in January 2014 to December were the determination of the 150 patients who underwent urinary minimally invasive,white blood cells（WBC）,CRP and serum procalcitonin level were examined,and were followed for the postoperative infection occurred,according to the degree of infection can be divided into no infection,mild infection and severe infection group,analysis and comparison between groups of CRP and serum calcitonin level difference is statistically significant,and analyzes the levels and the correlation between infection happened. Results The value of PCT in patients with severe infection group was obviously higher than that of mild infection and without infection,PCT,the WBC and CRP value difference between three groups has statistics significance（P〈0.01）. Merging different types of infection,the PCT,WBC,CRP value comparison differences statistically significant,and bacterial infection group was better than the average of virus and mycoplasma and chlamydia group. Groups of three indicators were compared,CRP mild infection positive rate is98%,both severe infection positive rate could reached 100%. Conclusion Simultaneous determination blood CRP and PCT is helpful to improve the specificity of the bacterial infectious diseases early judgment, the application of antimicrobial agents has certain reference value. Severe infection,PCT can be used as a important basis for predicting infection. Moderately elevated on a local or mild infection,PCT,and elevated CRP relatively obvious,in the absence of systemic infection,observation of CRP may be an important indicator.