肝移植术后降钙素原水平的变化特点及其对术后感染的诊断价值

Changes of procalcitonin levels and its diagnostic value for postoperative infection after liver transplantation

目的：观察肝移植患者术后降钙素原（PCT）的变化特点,并探讨PCT对肝移植术后感染的诊断价值,为临床早期诊断肝移植术后感染提供参考。方法：选择85例肝移植手术患者,根据病原学检测分为感染组（n=24,其中肺部感染18例、腹腔感染5例、血行感染1例）和非感染组（n=61）。比较两组PCT浓度,通过操作者工作特征曲线分析PCT的诊断价值。结果：患者PCT水平在肝移植术后（postoperative day,POD）第1天（POD 1）显著升高,POD 2达峰值,然后逐渐下降,POD 5降至1ng/mL以下并继续下降。感染组患者POD 5-14PCT水平高于非感染组,且高于排异反应者（P〈0.01）。结论：PCT水平对诊断肝移植POD 5-14感染有较好的敏感性和特异性。

Objective： To observe the changes of procalcitonin （PCT） after liver transplantation and investigate its diagnostic value in patients with liver transplantation, and provide reference for early diagnosis of infection. Methods： 85 cases of liver transplantation were analyzed retrospectively. According to the pathogen detection results, they were divided into infection group （n =24, pulmonary infection in 18 eases, abdominal infection in 5 cases, blood infection in 1 case） and non- infection group （n = 61）. PCT concentrations were compared between the two groups. The diagnostic value of PCT was analyzed by means of receiver operating. Results： PCT levels in liver transplantation patients were significantly elevated on the first postoperative day （POD 1）, reached the peak on the second day （POD 2）, and then decreased gradually from POD 5 to below 1 ng/mL. The levels of PCT in patients with postoperative infection were significantly higher than those in the non- infection group from POD 5 to POD 14. The PCT levels were significantly lower in the acute rejection group than in the infection group （P〈0.01） . Conclusions： The level of PCT has good sensitivity and specificity in the diagnosis for infection in patients 5-14 days after liver transplantation.