兔创伤性肠破裂早期血清降钙素原及C反应蛋白的检测及其意义

Detection and significance of early serum calcitonin and c-reactive protein in rabbit with traumatic intestinal rupture

目的探讨血清降钙素原(PCT)及C-反应蛋白(CRP)、WBC对创伤性肠破裂的早期诊断意义。方法选取40只健康雄性白兔,按随机数字表法分为4组:盲肠穿破组、盲肠横断组、假手术组、对照组,每组各10只。麻醉后无菌条件下手术制作盲肠穿破(直径0.5cm)组10只,盲肠横断组10只;假手术组及对照组各10只,制模后禁食,自由饮水。制模前、制模后1、3、6、8、12小时采集兔耳静脉血2ml,其中1ml血行全自动血细胞分析仪行WBC计数,其余血放-70℃冷藏待检,用Elisa法统一检测血清PCT、CRP水平。结果 (1)盲肠穿破组、盲肠横断组在制模后血清PCT、CRP和外周血WBC计数值逐渐升高,假手术组及对照组PCT、CRP、WBC值未见明显升高;(2)盲肠穿破组在制模后PCT、CRP、WBC值升高幅度较低,与盲肠横断组比较差异显著(P<0.05)。盲肠横断组于制模后6、12小时PCT值较CRP、WBC值上升速度快;(3)盲肠穿破组、假手术组、对照组兔全部存活,而盲肠横断组兔于24小时内全部死亡。结论 PCT联合CRP、WBC对兔盲肠外伤的早期诊断有一定的参考价值,能反应出盲肠损伤与腹膜炎的严重程度,并且PCT在盲肠横断组中敏感性要优于其余指标。

Objective To investigate the significance of serum procalcitonin（PCT）, C reactive protein（CRP） and WBC in the early diagnosis of traumatic intestinal rupture. Methods Forty healthy male rabbits were randomly divided into 4 groups： cecal puncture group,cecal transection group, sham operation group and control group. 10 rats in the cecal perforation group（0.5 cm in diameter） and 10 rats in the cecal transection group under the condition of anesthesia. 10 rats in the sham operation and control group. Before model making,1,3,6,8 and 12 hours after model making,2 ml of rabbit ear vein blood was collected.WBC was calculated by automatic blood cell analyzer. The rest of the blood was negative 70 degrees refrig-erated for inspection,and serum PCT and CRP level was uniformly detected by Elisa method. Results PCT,CRP and WBC increased gradually after cecal puncture and cecal transection,then PCT, CRP and WBC in sham operation and control group were not significantly increased.The increase of PCT, CRP and WBC in cecal puncture group was lower than that in cecal transection group（ P〈0.05）. The PCT values of cecum transverse section increased faster than those of CRP and WBC at 6 and 12 hours after model making. All rabbits in cecal perforation group, sham operation group and control group were survived,and therabbits incecal transection group weredied within 24 hours. Conclusion PCT combined with CRP and WBC has a certain reference value for early diagnosis of cecal injury in rabbits. It can reflect the severity of cecum injury and peritonitis.The sensitivity of PCT was better than the other indexes in the group of cecum transverse rupture.