血清降钙素原在腹膜透析相关性腹膜炎中的临床价值

Clinical value of serum procalcitonin in peritoneal dialysis-related peritonitis

目的探讨血清降钙素原(PCT)对腹膜透析(PD)相关性腹膜炎患者的早期诊断及疗效评估的临床价值。方法选择2015年10月~2016年10月我院腹膜透析中心的60例腹膜透析患者,根据是否发生腹膜透析相关感染分为感染组(30例)和非感染组(30例),另选30例择健康体检者作为健康对照组,检测三组的白细胞计数(WBC)、C反应蛋白(CRP)及PCT浓度,并动态观察上述指标在腹膜透析相关性腹膜炎患者治疗前后的变化,分析PCT与CRP、WBC的关系。结果与非感染组PD患者和健康对照组比较,感染组的血清PCT水平显著升高,差异有统计学意义(P<0.05);与健康对照组比较,非感染组和感染组的血清CRP水平均显著升高,差异有统计学意义(P<0.05);白细胞在三组间比较差异无统计学意义(P>0.05)。抗感染治疗后,感染组治疗前后的血清PCT与CRP比较,差异有统计学意义(P<0.05),WBC治疗前后无变化(P>0.05);血清PCT与CRP水平成正相关(P<0.05)。结论血清PCT可以作为诊断腹膜透析相关性腹膜炎及判断疗效的早期敏感指标。

Objective To investigate the clinical value of serum procaicitonin（PCT） in the early diagnosis and evaluation of curative effect for the patients with peritoneal dialysis（PD）-related peritonitis.Methods 60 patients receiving PD in the center of PD in our hospital from October 2015 to October 2016 were selected.According to whether PD related infection occurred,the patients were divided into the infection group（30 cases） and the non-infection group（30cases）.Another 30 healthy subjects were selected as the control group.The white blood cell count（WBC）,C-reactive protein（CRP） and PCT concentration were tested in the three groups.The changes of the above indicators in the patients with PD-related peritonitis before and after the treatment were dynamically observed,and the relationships between PCT and CRP,WBC were analyzed.Results Compared with the non infection group PD patients and the healthy control group,the serum PCT level of the infection group was significantly higher,the difference was statistically significant（P〈0.05）.Compared with the healthy control group,the levels of serum CRP in the non-infection group and the infection group were significantly higher,the difference was statistically significant（P〈0.05）.There was no statistically significant difference in the level of white blood cells between the three groups（P 〉0.05）.After the anti-infection treatment,there was statistically significant differences in serum PCT and CRP in the PD patients in the infection group before and after the treatment（P〈0.05）,and there was no change of WBC before and after the treatment（P〉0.05）.There was a positive correlation between serum PCT and CRP（P〈0.05）.Conclusion Serum PCT can be used as an early sensitive index for the diagnosis of PD-related peritonitis and judgment of its efficacy.