降钙素原对腹腔肿瘤术后患者并发腹腔感染的诊断价值

The diagnostic value of procalcitonin in postoperative abdominal infection in patients with abdominal tumor

目的评估降钙素原(PCT)对腹腔肿瘤术后患者并发腹腔感染的诊断价值。方法选择行腹腔肿瘤术后转入重症监护病房(ICU)的患者88例,根据患者是否合并腹腔感染分为感染组48例和对照组40例。患者转入ICU及治疗24、48、72 h时,采用电化学发光法检测PCT,流式细胞术检测白细胞计数(WBC),免疫比浊法检测C-反应蛋白(CRP);采用受试者工作特征(ROC)曲线评价PCT、WBC、CRP对腹腔感染的诊断价值。结果2组患者PCT在治疗24 h时最高,治疗48 h、72 h逐渐降低(P<0.05);感染组WBC治疗24 h时最高,治疗48 h、72 h逐渐降低(P<0.05),对照组WBC呈持续下降趋势(P<0.05);2组CRP在治疗24 h、48 h时逐渐升高,治疗72 h降低(P<0.05)。感染组患者PCT、CRP、WBC均高于对照组(P<0.05)。ROC曲线显示,PCT、WBC、CRP诊断腹腔感染的曲线下面积分别为0.696(95%CI:0.585~0.808)、0.538(95%CI:0.416~0.660)、0.572(95%CI:0.452~0.691),PCT对肿瘤术后患者并发腹腔感染的诊断价值优于WBC、CRP。结论PCT可作为腹腔肿瘤术后患者并发腹腔感染的辅助诊断指标之一。

Objective To evaluate the diagnostic value of procalcitonin(PCT)in patients with abdominal infection after abdominal tumor operation.Methods Eighty-eight patients who were transferred to intensive care unit(ICU)after abdominal tumor surgery were selected.The patients were divided into infection group(n=48)and control group(n=40)according to whether they had abdominal infection.When the patients were transferred to ICU and treated for 24 h,48 h and 72 h,PCT,white blood cell count(WBC)and C-reactive protein(CRP)were detected by electrochemiluminescence,flow cytometry and immunoturbidimetric assay.Receiver operating curve(ROC)was used to evaluate the diagnostic value of PCT,WBC and CRP in abdominal infection.Results The PCT levels were the highest at 24 h after treatment in the two groups,and decreased gradually at 48 h and 72 h after treatment(P<0.05).The WBC level was the highest at 24 h after treatment in infection group,and gradually decreased at 48 h and 72 h after treatment(P<0.05),while WBC showed a continuous downward trend in control group(P<0.05).The CRP level increased gradually at 24 h and 48 h after treatment in both groups,and decreased 72 h after treatment(P<0.05).The values of PCT,CRP and WBC were higher in the infection group than those in the control group(P<0.05).ROC curves showed that the areas under the curves of PCT,WBC and CRP were 0.696(95%CI:0.585-0.808),0.538(95%CI:0.416-0.660)and 0.572(95%CI:0.452-0.691),respectively.The diagnostic value of PCT was better for postoperative abdominal infection than that of WBC and CRP.Conclusion PCT can be used as one of the auxiliary diagnostic indexes of abdominal infection in patients with abdominal tumor after operation.