PCT检测对口腔颌面部多间隙感染病情及预后的意义

SERUM PROCALCITONIN DETECTION:ITS SIGNIFICANCE IN EVALUATING CONDITION AND PROGNOSIS OF PATIENTS WITH ORAL AND MAXILLOFACIAL MULTIPLE SPACE INFECTION

目的探讨血清降钙素原（PCT）在口腔颌面部多间隙感染病情及预后评估中的价值。方法选择2014年1月—2016年6月收住我院口腔科的口腔颌面部多间隙感染病人83例作为观察组,选择同期收住我科的非感染性疾病病人30例作为对照组。根据是否发展为脓毒症将观察组病人分为全身感染组和局部感染组。比较观察组和对照组间、全身感染组和局部感染组间入院时血清PCT、C-反应蛋白（CRP）、血常规白细胞计数（WBC）和中性粒细胞比例（NEU%）以及心率（P）,并比较住院期间不同PCT水平病人病情和预后情况。结果观察组PCT、CRP、WBC、NEU%和P值显著高于对照组（t=1.99-12.89,P〈0.05、0.01）。全身感染组PCT、WBC和P值显著高于局部感染组（t=2.26-13.29,P〈0.05、0.01）,而两组CRP和NEU%比较差异无显著性（P〉0.05）。与PCT〈5.0μg/L组比较,PCT≥5.0μg/L组病人脓毒症发生率显著升高（χ2=29.20,P〈0.01）,住院时间及ICU住院时间均明显延长（t=6.87、9.00,P〈0.01）。PCT≥5.0μg/L组病人中2例因感染性休克、多器官功能衰竭死亡,PCT〈5.0μg/L组病人无死亡病例,两组比较差异无显著性（P〉0.05）。结论常规监测血清PCT水平可以较为准确地反映口腔颌面部多间隙感染病情,并可作为临床治疗的参考指标之一。

Objective To investigate the value of serum procalcitonin（PCT）in assessment of condition of the illness and prognosis in patients with oral and maxillofacial multiple space（OMFMS）infection. Methods A total of 83 patients with OMFMS infection-treated in our department from January 2014 to June 2016-were selected to be served as observation group,and 30 patients with non-infectious disease treated in our department of corresponding period were served as controls.According to whether or not sepsis was developed,patients in the observation group were divided into systemic infection group and local infection group.The level of PCT,C-reactive protein（CRP）,heart rate（P）,white blood cell count（WBC）and blood neutrophil proportion（NEU%）,on admission,were compared between observation group and control group,between systemic infection group and local infection group,as well as the conditions and prognosis of patients with different PCT levels during their hospital stay. Results Compared with the control group,the serum PCT,CRP,WBC,NEU%and P in the observation group increased significantly（t=1.99-12.89;P〈0.05,0.01）.Compared with the local infection group,the serum PCT,WBC and P of systemic infection group were significantly higher（t=2.26-13.29;P〈0.05,0.01）,and the differences in CRP and NEU% values between the two groups were not significant（P〉0.05）.Compared with PCT 5.0μg/L group,sepsis occurred in PCT≥5.0μg/L group was increased significantly（χ2=29.20,P〈0.01）,the hospitalization and length of ICU stay were significantly prolonged（t=6.87,9.00;P〈0.01）.There were two patients in PCT≥5.0μg/L group died of septic shock and multiple organ failure,and in PCT〈5.0μg/L group,no death was recorded,the difference was not significant（P〉0.05）. Conclusion Routine monitoring of serum PCT levels can more accurately reflect the condition of patients with oral and maxillofacial multiple space infection,which can be used as one of the reference indexes in clinical therapy.