血清降钙素原对多发伤合并感染患者病情变化及预后的临床研究

摘要

目的 观察血清降钙素原与多发伤合并感染患者病情变化及预后的关系.方法 选取本院2015年4月至2017年4月收治的80例多发伤合并感染患者为观察组,同时期住院未合并感染患者80例作为对照组,两组均接受血清降钙素原水平检查,同时对患者伤情严重程度(Injury severity score,ISS)进行评定,检测并观察患者血糖(Blood sugar,BS)、肌酐(Creatinine,Cr)、丙氨酸转氨酶(Alanine transaminase,ALT)、中性粒细胞计数(polymorphonuclear neutrophils,PMN)等与患者血清降钙素原水平之间的相关性,观察多发伤合并感染患者与未感染患者的血清降钙素原水平,并比较多发伤患者感染前后的血清降钙素原水平.结果 多发伤合并感染患者发病后不同时间段的血清PCT、BS、Cr、ALT、PMN、ISS水平均显著高于对照组,差异有统计学意义(P＜0.05);且对症治疗后,多发伤合并感染患者伤后第PCT、BS、Cr、ALT、PMN、ISS水平均治疗前均有所改善,差异均有统计学意义(P＜0.05).多发伤合并感染患者各时间点PCT水平与BS、Cr、ALT、PMN、ISS水平呈正相关性(P＜0.05).多发伤患者感染前血清PCT水平(2.57±0.51)μg/L,感染后为(7.52±1.89) μg/L,感染后较感染前血清PCT水平显著升高,差异有统计学意义(t=22.62 P＜0.01).结论 多发伤可导致机体内血清降钙素原水平显著升高,且降钙素水平的不断升高与患者病情严重程度、病情变化趋势、感染情况等密切相关,为多发伤患者检测其血清降钙素原水平能够及时发现患者是否合并感染,可作为患者病情变化及预后评估的重要指标.%Objective To observe the relationship between the changes of patients' conditions and the prognosis of patients with multiple injuries complicated by infection treated with serum procalcitonin.Methods 80 patients with multiple injuries complicated by infection who had been seeking treatment in the hospital between April 2015 and April 2017 were selected as the observation group;another 80 cases of inpatients with infection during the same periods were selected as the control group.The detection of serum procalcitonin was applied in both groups.The injury severity score (ISS) of the patients was assessed,and the relationship between blood sugar (BS),creatinine (Cr),alanine transami nase (ALT),polymorphonuclear neutrophils (PMN),and the level of serum procalcitonin were analyzed.The serum procalcitonin level of patients with multiple injuries complicated by infection and those without infection was observed,and the serum procalcitonin level of patients with multiple injuries was compared before and after infection.Results The levels of PCT,BS,Cr,ALT,PMN and ISS in patients with multiple injuries complicated by infection at various time points were shown to be significantly higher than the control group,and the difference was statistically significant (P＜0.05);after symptomatic treatment,the levels of PCT,BS,Cr,ALT,PMN and ISS in patients with multiple injuries complicated by infection were all improved than before treatment,and the difference was statistically significant(P ＜0.05).The level of PCT level and the levels of BS,Cr,ALT,PMN and ISS at different time points were shown to be positively correlated at various time points(P＜0.05).The level of serum PCT in patients with multiple injuries complicated by infection was (2.57±0.51) μg/L before infection,and was (7.52 ± 1.89) μg/L after infection,and the level of serum PCT was significantly higher than that before infection,with statistically significant difference (t =22.62,P＜ 0.01).Conclusion Multiple injuries can cause the increase of serum procalcitonin in patients,and the continuous increase of serum procalcitonin level was closely correlated to the severity and changes of the patients' conditions and infection.The detection of serum procalcitonin level in patients with multiple injuries complicated by infection can help to find out whether there is infection complicated,thus providing an important indicator as a change of the patient's condition and prognosis.