血清降钙素原在重症医学科感染患者中的应用价值

The value of procalcitonin in ICU patients with severe infections

目的:观察不同重症感染类型疾病中降钙素原(procalcitonin,PCT)的差异性,明确PCT在感染严重程度、感染部位、病原菌的差异性。方法:选取感染性疾病患者90例。根据感染严重程度分为严重感染、脓毒症、脓毒性休克。根据感染部位,分为肺部感染、腹腔感染、颅内感染、尿路感染和血流感染。根据病原菌,分为革兰阳性菌、革兰阴性菌和真菌感染。研究感染严重程度、感染部位、不同菌株感染中血清PCT水平的差异性。结果:随着感染严重程度的升高,PCT水平升高,血清PCT水平与APACHEⅡ呈正相关(r=0.626,P<0.05)。在3组不同严重程度感染中,PCT水平有显著差异(P<0.01)。血流感染组PCT水平与其他部位各组具有显著差异(P<0.01)。PCT水平在病情程度相同的革兰阳性菌、革兰阴性菌和真菌感染中无显著差异(P>0.05)。结论:PCT对重症感染的评估具有重大意义,可用于判断重症感染的严重程度,对血流感染有一定鉴别作用,对不同病原菌无鉴别作用。

Objective： To observe the difference of procalcitonin in different types of severe infection,and to determine the difference in the severity of infection,the location of infection and the pathogen. Methods：A total of 90 patients were enrolled in the study. According to the severity of infection,the patients were divided into severe infection,sepsis and septic shock. According to the site of infection,they were divided into pulmonary infection,abdominal infection,intracranial infection,urinary tract infection and bloodstream infection. According to the pathogenic bacteria,gram positive bacteria,gram negative bacteria and fungal infections were classified. To study the difference of serum procalcitonin level in infection severity,infection site and infection of different strains. Results：With the increase of the severity of infection,the level of PCT increased,and the level of serum PCT was positively correlated with APACHEⅡ（ r = 0. 626,P〈0. 05）. There were significant differences in PCT levels between the three groups with different severity of infection（ P〈0. 01）. There was significant difference in PCT between bloodstream infection group and other groups（ P〈0. 01）. There was no significant difference in the level of PCT in gram positive bacteria,gram negative bacteria and fungal infections（ P〉0. 05）.Conclusion：Procalcitonin is of great significance in the evaluation of severe infection in ICU. It can be used to judge the severity of severe infection,and it has a certain role in the identification of bloodstream infection and has no differential effect on different pathogens.