PCT、CRP对于重症颅脑损伤患者肺部感染早期诊断价值的研究

发布时间：2018-12-15 19:58

【摘要】：目的：探讨PCT、CRP等炎性标记物实验室检测对重症颅脑损伤患者肺部感染早期诊断的价值。方法：选取外伤后直接收住重症医学科的63例重症颅脑损伤患者,其中男39例,女24例,年龄为14～85岁,平均年龄(40±4.25)岁。入住ICU后1h内留取血标本,然后收集患者每日的临床资料,记录体温峰值(℃)、白细胞计数(WBC)及中性粒细胞(NEU)、急性时相反应蛋白(CRP)、降钙素原(PCT),结合微生物指标、影像检查结果作为观察指标列表。所有参数设置与实验步骤均严格按其操作规程进行。根据最终临床特征和实验室检查结果,将患者分为非感染组和感染组。所有数据以SPSS13.0统计软件处理,统计学处理正态分布的计量资料用x±s表示,2个样本均数比较采用两组完全随机化设计资料均数的t检验,检验水准α=0.05。P0.05为差异有统计学意义。结合指标列表探讨上述指标对重症颅脑损伤患者肺部感染早期诊断及治疗的临床意义。结果：1.感染组血清中PCT检测阳性率为97.3%,CRP检测阳性率为100%,PCT、CRP含量均明显高于非感染组,差异均具有统计学意义(P0.05);2.PCT、 CRP对重症颅脑损伤患者肺部感染早期诊断灵敏度分别为76%、81%,特异度分别为69%、15%。3.联合检测灵敏度、特异度分别为81%、77%。结论：PCT联合CRP检测阳性率及特异性高,故联合监测重症颅脑损伤患者血清中PCT和CRP含量可作为ICU重症颅脑损伤患者继发肺部感染早期较特异和敏感指标。
[Abstract]:Objective: to investigate the value of laboratory detection of PCT,CRP and other inflammatory markers in the early diagnosis of pulmonary infection in patients with severe craniocerebral injury. Methods: a total of 63 patients with severe craniocerebral injury were enrolled in this study, including 39 males and 24 females, aged from 14 to 85 years, with an average age of (40 卤4.25) years. Blood samples were collected within 1 hour after admission to ICU, and daily clinical data were collected to record the peak temperature (C), white blood cell count (WBC) and neutrophil (NEU), acute phase reactive protein (CRP), procalcitonin (PCT),. Combined with microbial indicators, the imaging results were used as a list of observed indicators. All parameters and experimental steps are strictly in accordance with its operating procedures. According to the final clinical features and laboratory results, the patients were divided into non-infection group and infection group. All the data were processed by SPSS13.0 statistical software, the statistical data of normal distribution were expressed by x 卤s, and the mean of two samples were compared by using the t test of two groups of completely randomized design data mean. The difference of test level 伪 = 0.05.P0.05 was statistically significant. To explore the clinical significance of the above indexes in the early diagnosis and treatment of pulmonary infection in patients with severe craniocerebral injury. Results: 1. The positive rate of PCT detection in infected group was 97.3%. The positive rate of PCT in infected group was significantly higher than that in non-infected group (P0.05). 2. The sensitivity of PCT and CRP in the early diagnosis of pulmonary infection in patients with severe craniocerebral injury were 76 ~ 81, and the specificity were 69 ~ 15. 3 respectively. The sensitivity and specificity of combined detection were 81% and 77%, respectively. Conclusion: the positive rate and specificity of PCT combined with CRP are high, so the combined monitoring of PCT and CRP in serum of patients with severe craniocerebral injury can be used as a specific and sensitive index in the early stage of secondary pulmonary infection in patients with ICU severe craniocerebral injury.
【学位授予单位】：青岛大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R651.15

【参考文献】