降钙素原水平改变对类风湿关节炎置换术后早期感染的意义

发布时间：2018-03-17 19:12

本文选题：类风湿关节炎　切入点：人工关节置换术　出处：《中华医院感染学杂志》2017年06期 　论文类型：期刊论文

【摘要】：目的研究降钙素原水平变化在类风湿关节炎置换术后早期感染的意义,旨在为患者早期控制感染、阻断疾病演变、降低并发症发生率。方法选取2012年2月至2016年3月类风湿关节炎置换术后感染者20例为感染组,未感染者222例为未感染组,健康体检者48例为对照组。比较术前、术后48h红细胞沉降率(ESR)、白细胞计数(WBC)、C-反应蛋白(CRP)、降钙素原(PCT)水平。结果术前感染组ESR水平为(31.10±7.90)mm/h、CRP为(8.20±2.01)mg/L,未感染组为(33.00±4.00)mm/h、(8.00±1.30)mg/L,均高于对照组(19.50±3.00)mm/h和(5.34±2.20)mg/L,差异有统计学意义(P0.05);感染组PCT水平为(0.31±0.11)ng/mL、WBC水平为(9.50±3.04)×109/L,未感染组分别为(0.33±0.12)ng/mL、(9.62±3.44)×109/L与对照组(0.24±0.15)ng/mL和(8.23±1.21)×109/L比较,差异无统计学意义;术后48h,感染组、未感染组ESR分别为(69.04±9.80)mm/h、(42.13±11.30)mm/h,PCT为(12.60±1.96)ng/mL、(5.54±3.17)ng/mL,CRP为(23.08±6.87)mg/L、(12.20±3.56)mg/L及WBC为(18.63±4.98)×109/L、(11.98±2.15)×109/L均高于术前,差异有统计学意义(P0.05);术后48h,感染组ESR、PCT、CRP及WBC水平均高于对照组,差异有统计学意义(P0.05)。ESR水平敏感度89.58%、PCT91.67%,优于CRP79.17%、WBC60.42%,PCT水平特异性89.18%、阳性预测值67.69%优于ESR、CRP、WBC指标。PCT曲线下面积0.872,截断值10.50ng/mL。结论PCT水平变化有助于类风湿关节炎置换术后早期感染诊断,且PCT的截断值10.50ng/mL,能为临床早期诊断提供参考。
[Abstract]:Objective to study the significance of the change of procalcitonin level in the early infection after rheumatoid arthritis replacement, in order to control the infection early and block the disease evolution. Methods from February 2012 to March 2016, 20 patients with rheumatoid arthritis were selected as infection group, 222 uninfected patients as uninfected group and 48 healthy persons as control group. 48 hours after operation, erythrocyte sedimentation rate and leukocyte count were significantly higher than those in the control group (19.50 卤3.00 mm / h and 5.34 卤2.20 mg / L vs 5.34 卤2.20 mg / L, P < 0.05). Results the ESR levels in the infection group before operation were 31.10 卤7.90 mm / h and 8.20 卤2.01 mg / L respectively, and those in the non-infected group were 8.00 卤1.30 mg / L, respectively, which were significantly higher than those in the control group (19.50 卤3.00 mm / h and 5.34 卤2.20 mg / L, respectively). The PCT levels were 0.31 卤0.11ng / mL and 9.50 卤3.04脳 109 / L, respectively, and 0.33 卤0.12ng / mLnL in the uninfected group compared with 0.24 卤0.15ng / mL and 8.23 卤1.21 脳 109L / L in the control group, respectively, compared with the control group (0.24 卤0.15ng / mL and 8.23 卤1.21) 脳 109L / L, respectively, and compared with the control group (0.24 卤0.15ng / mL and 8.23 卤1.21) 脳 109L / L, respectively. At 48h after operation, the ESR of infection group and uninfected group were 42.13 卤11.30 卤11.30 卤12.60 卤1.96 ng / mL respectively, 5.54 卤3.17 ng / mL / mL of ESR were 23.08 卤6.87 mg / mL / L and 18.63 卤4.98 脳 10 9 卤11.98 卤2.15 脳 10 9 / L, respectively, and the levels of ESRPCTCRP and WBC in infection group were significantly higher than those in control group at 48 h after operation, the levels of WBC and ESRPCTCRP were significantly higher than those of control group (P < 0.05), and the WBC were 18.63 卤4.98 卤11.98 卤2.15) 脳 10 9 / L respectively, and the levels of ESRPC TCRP and WBC were significantly higher in the infection group than in the control group at 48 h after operation. The sensitivity of PCT91.67 was better than that of CRP79.17. The specificity of PCT was 89.18. The positive predictive value of 67.69% was better than the area under the curve of 0.872.The truncation value was 10.50ngmL.Conclusion the change of PCT level is helpful to the diagnosis of early infection after rheumatoid arthritis replacement, the positive predictive value is 67.69%, and the area under the curve is 0.872.Conclusion the change of PCT level is helpful to the diagnosis of early infection after rheumatoid arthritis replacement. The truncation value of PCT is 10.50 ng / mL, which can provide reference for early clinical diagnosis.
【作者单位】：遵义市第一人民医院骨科;遵义市第一人民医院检验科;
【基金】：贵州省科技合作计划基金资助项目(黔科合LH字(2015)7575)
【分类号】：R687.4

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