血清PGE_2与PCT及CRP检测对腹部创伤感染的价值

Clinical value of serum PGE_2,PCT and CRP in diagnosis of abdominal wound infection

目的探讨血清C-反应蛋白(CRP)、降钙素原(PCT)、血清前列腺素E_2(PGE_2)在腹部创伤感染中的临床诊断价值。方法选择2016年1月-2017年1月医院腹部创伤感染患者108例为观察组,另选同期未发生感染的腹部创伤患者100例为对照组,对比两组患者血清CRP、PCT、PGE_2水平及上述指标的特异度、灵敏度、诊断准确率,分析其在腹部创伤感染诊断中的临床价值。结果观察组血清CRP、PCT水平分别为(65.84±2.65)mg/L与(3.37±0.69)ng/L,均高于对照组,差异有统计学意义(P<0.05),观察组血清PGE_2水平为(42.05±1.83)ng/L,高于对照组,差异有统计学意义(P<0.05);血清CRP、PCT、PGE2预测腹部创伤患者发生感染风险的ROC曲线的AUC分别为0.88(95%CI为0.79~0.92)、0.93(95%CI为0.81~0.96)、0.85(95%CI为0.77~0.89);当血清CRP、PCT、PGE2分别为8mg/L、0.25ng/L、26.00ng/L时,其预测腹部创伤患者发生感染的灵敏度分别为86.79%、90.09%与90.62%,特异度分别为88.23%、93.81%与84.82%。结论在腹部创伤感染诊断中,血清CRP、PCT、PEG2的特异度、灵敏度及诊断准确率均较高,具有良好的临床诊断价值。

OBJECTIVE To explore the clinical value of serum C-reactive protein（CRP）,procalcitonin（PCT）and serum prostaglandin E2（PGE2）in diagnosis of abdominal wound infection.METHODS Totally 108 patients with abdominal wound infection who were treated in the hospital from Jan 2016 to Jan 2017 were chosen as the control group,meanwhile,100 abdominal wound patients without infection were set as the control group.The levels of serum CRP,PCT and PGE2 were compared between the two groups of patients;the specificity,sensitivity and accuracy of diagnosis of the above indexes were determined,and the clinical value in diagnosis of the abdominal wound infection was analyzed.RESULTS The levels of serum CRP and PCT of the observation group were（65.84±2.65）mg/L and（3.37±0.69）ng/L,respectively,significantly higher than those of the control group（P〈0.05）;the serum PGE2 level of the observation group was（42.05±1.83）ng/L,significantly higher than that of the control group（P〈0.05）.The AUC of ROC of the serum CRP was 0.88（95%CI ：0.79～0.92）in prediction of infection in the patients with abdominal wound,the serum PCT 0.93（95%CI ：0.81～0.96）,the serum PGE2 0.85（95%CI ：0.77～0.89）.The sensitivity and specificity of the serum CRP were respectively 86.79%and 88.23%in the prediction of infection in the patients with abdominal wound when it was 8 mg/L;the sensitivity and specificity of the serum PCT were respectively 90.09%and 93.81%when it was 0.25 ng/L;the sensitivity and specificity of the serum PGE2 were respectively 90.62%and 84.82%when it was 26.00 ng/L.CONCLUSION The sensitivity,specificity and accuracy of the serum CRP and PCT are high in the diagnosis of infection in the patients with abdominal wound,and they have high clinical diagnostic value.