动态监测降钙素原在颅脑术后患者发生医院感染的临床意义

Clinical significance of dynamic monitoring of procalcitonin in patients with nosocomial infection after craniocerebral operation

目的探讨动态监测降钙素原(procalcitonin,PCT)在颅脑术后发生医院感染的临床意义。方法对2013-01—2014-01行颅脑手术的176例患者的临床资料进行回顾性分析,其中术后发生医院感染的患者38例(感染组),未发生医院感染的患者138例(非感染组),分别在术后第1、3、5、7天采集静脉血标本检测血清PCT、C反应蛋白(CRP)、白细胞(WBC)数,同时选取同期健康体检者50例作为对照(对照组),以判断PCT水平变化对颅脑术后患者发生医院感染的预测价值。结果颅脑手术后第1天的血清PCT水平明显高于对照组(P<0.05),而血清CRP水平、WBC计数和对照组比较差异无统计学意义(P>0.05)。发生医院感染组和非医院感染组相比各时段血清PCT明显升高,差异有统计学意义(P<0.05);感染组血清CRP水平在术后第3、5天明显高于非感染组,差异有统计学意义(P<0.05),术后第1、7天和非感染组相比差异无统计学意义(P>0.05);感染组血清WBC计数和非感染组比较除第3天差异有统计学意义外,余差异均无统计学意义。结论动态监测PCT水平可较早预测颅脑术后发生医院感染。

Objective To investigate the clinical significance of dynamic determination of serum procalcitonin（PCT） level in patients with nosocomial infection after craniocerebral operation. Methods The clinical data of 176 patients with craniocerebral op eration from January 2013 to January 2014 was analyzed retrospectively. The patients with nosocomia infection were 38 cases（in fection group） ,the patients with non nosocomia infection were 138 cases（non-infection group）. Serum PCT levels were detected in the 176 patients after craniocerebral operation on the first, third, fifth, and seventh day. The C reactive protein（CRP） and white blood cell（WBC）count were detected at the same time. The same period of 50 healthy volunteers were control group. The predic tive value of the PCT level changes on the patients with nosocomial infection after craniocerebral operation was analyzed. Results Serum PCT level at the first day of the craniocerebral operation group was significant higher than the control group （P〈0. 05）, while serum CRP levels,WBC counts had no significant difference（P〉0.05）. Serum PCT level in the concurrent infection was significant higher than those in the non infection group at different time points （P〈0. 05）. Serum CRP level at the third,fifth day of the infection groups was significant higher than the non infection group （P〈0. 05） ,while at the first,seventh day. Serum WBC counts at the third day of the infection groups was significant higher than the non infection group （P〈0. 05） ,while at the first, fifth,seventh day. Conclusion Dynamic determination of serum PCTlevel in patients can predict the occurrence of nosocomial in fection early after craniocerebral operation.