外科腹腔感染患者PCT与TNF-α及CRP和IL-6水平与感染程度的研究

发布时间：2018-06-25 16:18

本文选题：外科 + 腹腔感染　；参考：《中华医院感染学杂志》2017年20期

【摘要】：目的观察外科腹腔感染患者血清降钙素原(PCT)、肿瘤坏死因子-α(TNF-α)、C-反应蛋白(CRP)和白细胞介素6(IL-6)的水平变化与感染程度的相关性,为临床指导抗菌药物应用提供依据。方法选择医院普通外科2012年11月-2016年12月收治的69例外科腹腔感染和24例非腹腔感染患者,依据腹腔感染范围不同,分为无感染组24例,局部感染组38例和弥漫性感染组31例,检测患者入院时及抗感染治疗第3天的体温(T)、白细胞(WBC)、中性粒细胞百分率(N%)、血清PCT、TNF-α、CRP和IL-6的水平,分析其与WBC的相关性。结果弥漫性感染组、局部感染组入院时T、WBC、N%、CRP、TNF-α和IL-6表达显著高于无感染组(P0.05);弥漫性腹腔感染组TNF-α和IL-6表达高于局部感染组;弥漫性感染组与局部感染组、无感染组比较,PCT表达明显升高;抗感染治疗3天后,两组感染患者T、WBC、N%、CRP、TNF-α、PCT和IL-6表达较入院时均明显下降(P0.05),而弥漫性感染组TNF-α、PCT和IL-6水平仍高于局部感染组。PCT、TNF-α、CRP、IL-6与WBC均呈正相关。结论临床检测血清PCT、TNF-α、CRP和IL-6均有助于鉴别是否存在外科腹腔感染,与CRP和WBC相比,PCT、TNF-α和IL-6检测更有助于评估腹腔感染严重程度,对抗菌药物应用有一定的指导作用。
[Abstract]:Objective to observe the correlation between the levels of serum procalcitonin (PCT), tumor necrosis factor- 伪 (TNF- 伪) C-reactive protein (CRP) and interleukin-6 (IL-6) and the degree of infection in patients with intraperitoneal infection. Methods from November 2012 to December 2016, 69 patients with intraperitoneal infection and 24 patients with non-celiac infection were divided into three groups: no infection group (n = 24), local infection group (n = 38) and diffuse infection group (n = 31). Body temperature (T), white blood cell (WBC), percentage of neutrophils (N%), serum levels of TNF- 伪 CRP and IL-6 were measured at admission and on the 3rd day of anti-infection therapy, and the correlation with WBC was analyzed. Results the expression of TNF- 伪 and IL-6 in diffuse infection group and local infection group was significantly higher than that in non-infection group (P0.05), the expression of TNF- 伪 and IL-6 in diffuse abdominal infection group was higher than that in local infection group, the expression of TNF- 伪 and IL-6 in diffuse infection group and local infection group was higher than that in local infection group, and the expression of TNF- 伪 and IL-6 in diffuse abdominal infection group was higher than that in local infection group. After 3 days of anti-infection treatment, the expression of TNF- 伪 -PCT and IL-6 in the two groups were significantly lower than those on admission (P0.05), while the levels of TNF- 伪 -PCT and IL-6 in diffuse infection group were still higher than those in local infection group. Conclusion Clinical examination of serum PCT TNF- 伪 CRP and IL-6 is helpful to distinguish the existence of surgical abdominal infection. Compared with CRP and WBC, the detection of TNF- 伪 and IL-6 is more helpful to evaluate the severity of intraperitoneal infection and has a certain guiding effect on the application of antimicrobial agents.
【作者单位】：杭州市红十字会医院普外科;
【基金】：浙江省医学会临床科研资金资助项目(2011zyc-B04)
【分类号】：R619.3

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