血糖、降钙素原及C反应蛋白联合应用在颅脑术后颅内感染早期诊断中的价值

The value of combined use of blood glucose,procalcitonin and C-reactive protein in the early diagnosis of intracranial infection after craniocerebral operation

目的:探讨血糖(GLU)、降钙素原(PCT)及C反应蛋白(CRP)联合应用在颅脑术后颅内感染早期诊断中的价值。方法:选取2016年1月至2018年12月沧州市人民医院神经外科颅脑术后颅内感染患者39例为实验组,未感染者62例为对照组。检测两组患者血清GLU、PCT及CRP水平,ROC曲线分析检测指标的诊断价值。结果:实验组和对照组术前1 d血清GLU、PCT及CRP水平差异无统计学意义。与术前1 d相比,实验组术后2 d血清GLU、PCT及CRP水平均明显上升(P<0.01),对照组无明显变化。GLU与PCT(r=0.708,P<0.01)和CRP(r=0.3909,P<0.01)呈正相关。GLU、PCT及CRP曲线下面积分别为0.7705、0.8945、0.8467(P<0.01)。GLU、PCT及CRP在5.28 mmol·L^-1、0.27 ng·ml^-1、15.71 mg·L^-1为最佳检测临界点。GLU、PCT及CRP联合诊断的ROC曲线下面积为0.9355(P<0.01),高于单项指标的ROC曲线下面积。结论:GLU、PCT和CRP联合应用能够高效早期诊断颅脑术后颅内感染。

Objective:To investigate the value of combined use of procalcitonin(PCT),C-reactive protein(CRP)and blood glucose(GLU)in the early diagnosis of intracranial infection after craniocerebral operation.Methods:From January 2016 to December 2018,39 patients with intracranial infection after cranial surgery treated at the Department of Neurosurgery in Cangzhou People’s Hospital were used as experimental group,and 62 cases without infection were used as control group.Serum PCT,CRP and GLU levels were measured in the two groups,and the diagnostic value of the ROC curve analysis indicators was analyzed.Results:One day before surgery,there was no significant difference in serum levels of GLU,PCT and CRP between the experimental group and the control group.Compared with the day before surgery,the serum levels of GLU,PCT and CRP in the experimental group were significantly higher than those two days after surgery(P<0.01).There was no significant change in the control group.GLU was positively correlated with PCT(r=0.708,P<0.01)and CRP(r=0.3909,P<0.01).The areas under the GLU,PCT,and CRP curves were 0.7705,0.8945,and 0.8467,respectively(P<0.01).The best detection critical points of GLU,PCT and CRP were at 5.28 mmol·L^-1,0.27 ng·ml^-1 and 15.71 mg·L^-1.The area under the ROC curve for the combined diagnosis of GLU,PCT and CRP was 0.9355(P<0.01),which was higher than that of the single index.Conclusion:The combination of GLU,PCT and CRP can efficiently diagnose intracranial infections after craniocerebral surgery.