降钙素原对腹部创伤合并腹腔感染患者病情预后的意义

摘要

ObjectiveTo investigate the prognostic signiifcance of serum calcitonin in the evaluation of severity of patients with acute abdomen trauma combined with abdominal infection.MethodsA total of one hundred and forty cases of acute abdominal trauma patients, according to whether or not the abdominal infection, were divided into simple abdominal trauma group (control group) which were sixty cases and eighty cases of abdominal trauma complicated with abdominal infection group (intraperitoneal infection group). According to the survival rate of patients in two weeks, the patients with abdominal infection were divided into survival group of iffty-seven cases and twenty-three cases of mortality group. On the ifrst, third, iffth days, the level of serum calcitonin(PCT) was used to detect by the peripheral venous blood, the serum calcitonin level change signiifcance was compared with each group of patients. The sequential organ failure score(SOFA) was recorded, and the correlation between the serum PCT and SOFA score was analyzed.ResultsThe level of serum calcitonin in abdominal trauma patients complicated with abdominal infection was signiifcantly higher than that in simple abdominal trauma group, there were signiifcant differences between the two groups (P<0.01). Admitted to hospital on the ifrst, third, iffth days, the serum calcitonin peptide in the simple group signiifcantly decreased, while intraperitoneal infection group showed a slow downward trend, the variation range of serum calcitonin in the simple group were greater than abdominal infection group within seventy-two hours, the difference between the two groups has statistical signiifcance (P<0.05). The serum PCT levels in the mortality group gradually increased with time.Meanwhile, the survival group showed a signiifcant decline trend in the same time, the difference between the two groups was statistically signiifcant(P<0.05). But on the ifrst,third,iffth day on admission, the serum PCT level and SOFA score was positively correlated (r1=0.421,r2=0.761,r3=0.836,P<0.01).ConclusionsDynamic observation of serum procalcitonin levels is helpful to improve the prognostic value of acute abdominal trauma combined with abdominal infection. The levels of serum procalcitonin and sequential organ failure score has a close correlation on the third day after admission.%目的：分析血清降钙素原对于腹部创伤合并腹腔感染患者病情预后临床意义。方法选择急性腹部创伤患者140例，依据患者是否合并腹腔感染分为单纯腹部外伤组（单纯组）60例与腹部外伤合并腹腔感染组（腹腔感染组）80例。依据患者2周内生存情况将腹腔感染组分为存活亚组57例和病死亚组23例。入院第1、3、5天，外周静脉血电化学发光法检测血清降钙素原（PCT），比较各组患者血清降钙素原水平变化意义。并记录当日序贯器官衰竭评分（SOFA），比较病死组患者血清PCT与SOFA评分之间相关性。结果腹部外伤合并腹腔感染组血清降钙素原水平明显高于单纯腹部外伤组，2组比较差异有统计学意义（P＜0.01）。入院第1、3、5天，单纯组血清降钙素原呈显著下降变化，而腹腔感染组呈缓慢下降趋势，单纯组72 h内血清降钙素原变化幅度大于腹腔感染组，2组比较差异有统计学意义（P＜0.05）。病死组入院第1、3、5天患者血清PCT水平呈逐渐升高趋势。而存活组呈显著下降变化，同时间点比较2组差异有统计学意义（P＜0.05）。但入院第1、3、5天血清PCT水平与SOFA评分呈正相关关系（r1=0.421，r2=0.761，r3=0.836，P＜0.01）。结论动态观察血清降钙素原水平变化有助于提高急性腹部外伤合并腹腔感染患者预后的判断价值。入院后第3天血清降钙素原水平与序贯器官衰竭评分相关性好。