重型颅脑损伤监测降钙素原和超敏C反应蛋白对感染的鉴别诊断应用

Differential Diagnosis of the Infection of the Procalcitonin and High Sensitive C Reactive Protein in the Monitoring of Severe Brain Injury

探讨重型颅脑损伤监测降钙素原和超敏C反应蛋白对感染的鉴别诊断应用。选择我院2015年1月至2016年1月所接诊的80例重型颅脑损伤患者,其中40例伴有肺部感染作为感染组,其余40例为未感染组,在感染当天检测降钙素原(PCT)、超敏C反应蛋白(hs-CRP)水平,感染组患者给予相应的抗感染治疗后,根据患者感染情况进行分组,在感染后3 d、感染后7 d时分别对PCT、hs-CRP水平进行检测。在感染当天,感染组PCT、hs-CRP水平均比未感染组高((3.85±0.51)ng/m L比(0.53±0.15)ng/m L,(61.23±17.34)mg/L比(50.12±13.12)mg/L)(p<0.05);在感染组患者中,24例患者感染好转,感染后3 d、感染后7 d时,PCT、hs-CRP水平均比确认感染当天得到降低(p<0.05);另外16例患者感染持续,在感染后3 d、感染后7 d时,PCT、hs-CRP水平均发生持续性升高,与确认感染当天比较差异具有统计学意义(p<0.05)。PCT和hs-CRP的检测在重型颅脑损伤并发肺部感染患者中具有较高的特异性敏感性,有利于临床评估。

To study differential diagnosis of the infection of the procalcitonin and high sensitive C reactive protein in the monitoring of severe brain injury. 80 patients with severe traumatic brain injury from January 2015 to January 2016 in our hospital were researched. 40 cases had pulmonary infection as infection group,the other 40 cases were uninfected group. Infection day, to detect the level ofprocalcitonin （PCT） and high sensitive C reactive protein （hs-CRP）, infection group were given the corresponding anti infection treatment, grouping according to the patient＇s infection, after infection, 3 d, 7 d, the levels of PCT and hs-CRP were detected respectively. Infection day, the levels of PCT and hs-CRP in the infection group were higher than those in the uninfected group （（3.85±0.51） ng/mL vs （0.53±0.15） ng/mL, （61.23±17.34） mg/L vs （50.12±13.12） mg/L） （/9 〈0.05）; In the infection group, 24 cases were improved, after infection 3 d, 7 d, the PCT, hs-CRP levels were lower than the confirmed infection day （p〈0.05）; the other 16 patients were infected continuously, the PCT and hs-CRP levels were increased continuously at the time of infection, the difference was statistically significant between the day and the confirmed infection （p〈0.05）. Det- ection of PCT and hs-CRP in patients with severe brain injury complicated with pulmonary infection has a high specificity sensitivity, conducive to clinical assessment.