C反应蛋白及前降钙素用于预测结直肠手术术后吻合口渗漏的比较

目的比较C反应蛋白（CRP）及前降钙素（PCT）用于预测结直肠手术术后吻合口渗漏（AL）的诊断价值。方法收集邯郸市第一医院2011至2015年普外科收治并接受结直肠手术并进行I期吻合的患者147例，所有患者在术后1周内每日均进行CRP及PCT检测，并对两者的变化趋势、临床特征、预后、诊断价值进行分析。结果AL的发生率为10．88％（16／147），AL组的平均住院天数（37．8±10．9）、平均住院费用（40799±13325元）、死亡率（12．50％）均明显高于非AL组（23．4±7．6天、33741±10673、3．82％（5／131）），P均〈0．05。CRP术后第二天的曲线下面积为0．602，截断值为83．5mg／L，敏感性为0．563，特异性为0，534。CRP术后第三天的曲线下面积为0．916，截断值为78．50mg／L，敏感性为1．000，特异性为0．595。PCT术后第一天曲线下面积为0．915，截断值为3．05μg／L，敏感性为0．875，特异性为0．611。PCT术后第二天曲线下面积为0．882，截断值为1．85μg／I。，敏感性为0．813，特异性为0．931。结论对于预测AI，而言，PCT的诊断价值优于CRP。

Objective to compare CRP and PCT regarding with early diagnosis of AL. Methods 147 patients underwent colorectum operation and primary anastomosis were collected from 2011 to 2014. All subjects received the measurement of CRP and PCT on days 1 to 7 after operation. In addition, the clinical characteristics, clinical outcomes, prognosis, and diagnostic value of CRP and PCT were evaluated. Results The incidence of AL was 10.88%. The higher hospital stay, cost, mortality were observed in AL group compared with non-Air group. For CRP, the area under curve, cut-off value, sensitivity, specificity on days 2 and days 3 after operation was 0. 602 and 0. 916, 83.5 and 78.5 mg/L, 0. 563 and 1. 000, 0. 534 and 0. 595, respectively. For PCT, the area under curve, cut off value, sensitivity, specificity on days 1 and 2 after operation was 0. 915 and 0. 882, 3.05 and 1.85μg/L, 0. 875 and 0. 813, 0. 611 and 0. 931, respectively. Conclusion In terms of predicting and early diagnosing purpose of AL, PCT is superior compared with CRP.