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目的探讨血清降钙素原(procalcitonin,PCT)在重症监护病房(intensivecareunit,ICU)患者感染中的临床价值。方法选取ICU收治的60例细菌感染患者,将其分为重症感染组28例、一般感染组32例,另选30例健康人为对照组;采用免疫层析法检测PCT水平,透射比浊法检测C反应蛋白(C-reactive protein,CRP)水平和荧光流式细胞计数法测定外周血白细胞(white blood cell,WBC)水平,并对部分患者血清PCT、CRP和WBC水平进行连续监测。结果重症感染组、一般感染组分别与对照组比较,PCT、CRP、WBC水平均有显著升高,差异有统计学意义(P<0.05);重症感染组的PCT、CRP比一般感染组有显著升高,差异有统计学意义(P<0.05);重症感染组的PCT阳性率明显高于一般感染组,差异有统计学意义(P<0.05);CRP、WBC阳性率在重症感染组与一般感染组之间比较差异均无统计学意义(P>0.05)。连续监测结果显示,PCT水平与患者病情密切相关,CRP和WBC对治疗效果的提示作用不如PCT。结论血清PCT对危重患者的细菌感染有较好的特异性和敏感性,对判断感染的严重程度及预后也有重要的临床参考价值。
Objective To investigate the clinical value of serum procalcitonin (PCT) in patients with intensive care unit (ICU) infection. Methods Sixty patients with bacterial infection admitted to ICU were divided into 28 cases of severe infection group, 32 cases of general infection group and 30 cases of healthy people as control group. The levels of PCT were detected by immunochromatographic assay and turbidimetric assay C-reactive protein (CRP) level and fluorescence flow cytometry were used to determine the level of white blood cell (WBC). Serum levels of PCT, CRP and WBC in some patients were monitored continuously. Results The levels of PCT, CRP and WBC in severe infection group and general infection group were significantly higher than those in control group (P <0.05). The PCT and CRP in severe infection group were significantly higher than those in general infection group (P <0.05). The positive rate of PCT in severe infection group was significantly higher than that in general infection group (P <0.05). The positive rates of CRP and WBC in severe infection group were significantly higher than those in general infection group There was no significant difference between the infected groups (P> 0.05). Continuous monitoring results show that the PCT level is closely related to the patient’s condition, CRP and WBC on the treatment effect is not as good as the PCT. Conclusions Serum PCT has good specificity and sensitivity to bacterial infection in critically ill patients, and also has important clinical reference value for judging the severity and prognosis of infection.