CAJ | 학술논문

目的探讨重症脑卒中患者血清降钙素原(PCT)水平连续监测的作用.方法随机选取我院收治的重症脑卒中患者86例,根据微生物学检查证实为是否细菌性感染将其分为感染组(n=48例)与非感染组(n=38例).两组患者均抽取空腹静脉血液检测PCT及C-反应蛋白(CRP)水平.结果感染组第1、4、7天PCT水平分别为(1.34±0.48) ng/ml、(3.61±1.40) ng/ml、(2.12±1.13) ng/ml,CRP水平分别为(12.76±5.12)mg/L、(18.68±8.12)mg/L、(13.27±5.19)mg/L,均显著高于非感染组[PCT(0.27±0.13) ng/ml、(0.37±0.07) ng/ml、(0.19±0.13) ng/ml,CRP(6.59±4.62) mg/L、(8.61±4.30)mg/L、(5.46±4.13) mg/L],差异有统计学意义(P＜0.05);以PCT＜0.5 ng/ml作为细菌感染阴性标准后,第1天诊断敏感度为81.3％,第4天为91.7％,第7天为87.5％,高于以CRP＜10.0mg/L作为细菌感染阴性标准的第1天的64.6％、第4天的85.4％及第7天的75.0％;诊断特异性:PCT与CRP第1天诊断特异性分别为94.7％、71.1％,差异有统计学意义(P＜0.05),第4天分别为89.5％、81.6％,第7天分别为86.8％、76.3％.结论对重症脑卒中患者的PCT水平进行连续性监测可更好地发现细菌感染,并指导抗生素使用.
목적 탐토중증뇌졸중환자혈청강개소원(PCT)수평련속감측적작용.방법 수궤선취아원수치적중증뇌졸중환자86례,근거미생물학검사증실위시부세균성감염장기분위감염조(n=48례)여비감염조(n=38례).량조환자균추취공복정맥혈액검측PCT급C-반응단백(CRP)수평.결과 감염조제1、4、7천PCT수평분별위(1.34±0.48) ng/ml、(3.61±1.40) ng/ml、(2.12±1.13) ng/ml,CRP수평분별위(12.76±5.12)mg/L、(18.68±8.12)mg/L、(13.27±5.19)mg/L,균현저고우비감염조[PCT(0.27±0.13) ng/ml、(0.37±0.07) ng/ml、(0.19±0.13) ng/ml,CRP(6.59±4.62) mg/L、(8.61±4.30)mg/L、(5.46±4.13) mg/L],차이유통계학의의(P＜0.05);이PCT＜0.5 ng/ml작위세균감염음성표준후,제1천진단민감도위81.3％,제4천위91.7％,제7천위87.5％,고우이CRP＜10.0mg/L작위세균감염음성표준적제1천적64.6％、제4천적85.4％급제7천적75.0％;진단특이성:PCT여CRP제1천진단특이성분별위94.7％、71.1％,차이유통계학의의(P＜0.05),제4천분별위89.5％、81.6％,제7천분별위86.8％、76.3％.결론 대중증뇌졸중환자적PCT수평진행련속성감측가경호지발현세균감염,병지도항생소사용.
Objective To explore the role of continuously monitoring serum procalcitonin level in severe stroke.Methods 86 patients with severe stroke confirmed by microbiological examination were randomly selected and were divided into an infected groups (n=48) and a non-infected group (n=38) in terms of whether was bacterially infected.All patients were tested PCT and C-reactive protein (CRP) levels by fasted venous blood.Results Day 1,4,and 7,the PCT levels were (1.34 ± 0.48) ng/ml,(3.61 ± 1.40) ng/ml,(2.12 ± 1.13) ng/ml and the CRP levels were (12.76 ± 5.12) mg/L,(18.68 ± 8.12) mg/L,and (13.27 ± 5.19) mg/L in the infection group respectively,which were significantly higher than those in the non-infected group (PCT levels:[0.27 ± 0.13] ng/ml,[0.37 ± 0.07] ng/ml,[0.19 ± 0.13] ng/ml; CRP levels:[6.59 ± 4.62] mg/L,[8.61 ± 4.30] mg/L,[5.46 ± 4.13] mg/L),with statistical differences (P ＜ 0.05).With PCT ＜ 0.5 ng/ ml as the standard negative bacterial infection,the PCT diagnostic sensitivity was 81.3％ on day 1,91.7％ day 4,and 87.5％ day 7.With CRP ＜ 10.0 mg/L as the standard negative bacterial infection,the sensitivities were 64.6％,85.4％,and 75.0％ on day 1,4,and 7,respectively.The diagnostic specificities of PCT and CRP were 94.7％ and 71.1％ on day 1,with statistical difference (P ＜ 0.05),89.5％ and 81.6％ day 4,and 86.8％ and 76.3％ day 7,respectively.Conclusions Continuously monitoring serum procalcitonin level can find out bacterial infections easily and guide antibiotic usage.