中华急诊医学杂志
中華急診醫學雜誌
중화급진의학잡지
CHINESE JOURNAL OF EMERGENCY MEDICINE
2012年
9期
1032-1036
,共5页
邓水香%曹同瓦%祝禾辰%王昆仑%方勇
鄧水香%曹同瓦%祝禾辰%王昆崙%方勇
산수향%조동와%축화신%왕곤륜%방용
降钙素原%颅脑外伤%感染%预后
降鈣素原%顱腦外傷%感染%預後
강개소원%로뇌외상%감염%예후
Procalcitonin%Brain trauma%Infection%Prognosis
目的 探讨血清降钙素原(PCT)与单纯脑外伤患者病情严重程度、并发症以及预后的关系.方法 采用前瞻性观察研究,入选120例单纯性脑外伤患者.分别于患者入院后第1、2、3、5、7、10天早上采集血标本检测血降钙素原和C反应蛋白(CRP)水平,收集患者入院10d内的临床资料并随访患者28 d后的生存情况.另选30例健康人群(正常组)作为对照.结果 轻、重度脑外伤患者各时段血PCT水平比较差异均具有统计学意义(P<0.05).感染组与非感染组PCT水平第1、2天比较,差异无统计学意义,但第3、5、7、10天比较差异具有统计学意义(P<0.05).Kaplan-Meier生存分析显示入院高PCT水平组与低PCT水平组患者28 d生存率差异具有统计学意义(P<0.05).结论 入院高PCT水平的患者病情更严重且更容易出现各种并发症包括感染且预后不良.动态监测血PCT水平可以作为判断单纯脑外伤患者病情、感染控制及预后的有效指标之一.
目的 探討血清降鈣素原(PCT)與單純腦外傷患者病情嚴重程度、併髮癥以及預後的關繫.方法 採用前瞻性觀察研究,入選120例單純性腦外傷患者.分彆于患者入院後第1、2、3、5、7、10天早上採集血標本檢測血降鈣素原和C反應蛋白(CRP)水平,收集患者入院10d內的臨床資料併隨訪患者28 d後的生存情況.另選30例健康人群(正常組)作為對照.結果 輕、重度腦外傷患者各時段血PCT水平比較差異均具有統計學意義(P<0.05).感染組與非感染組PCT水平第1、2天比較,差異無統計學意義,但第3、5、7、10天比較差異具有統計學意義(P<0.05).Kaplan-Meier生存分析顯示入院高PCT水平組與低PCT水平組患者28 d生存率差異具有統計學意義(P<0.05).結論 入院高PCT水平的患者病情更嚴重且更容易齣現各種併髮癥包括感染且預後不良.動態鑑測血PCT水平可以作為判斷單純腦外傷患者病情、感染控製及預後的有效指標之一.
목적 탐토혈청강개소원(PCT)여단순뇌외상환자병정엄중정도、병발증이급예후적관계.방법 채용전첨성관찰연구,입선120례단순성뇌외상환자.분별우환자입원후제1、2、3、5、7、10천조상채집혈표본검측혈강개소원화C반응단백(CRP)수평,수집환자입원10d내적림상자료병수방환자28 d후적생존정황.령선30례건강인군(정상조)작위대조.결과 경、중도뇌외상환자각시단혈PCT수평비교차이균구유통계학의의(P<0.05).감염조여비감염조PCT수평제1、2천비교,차이무통계학의의,단제3、5、7、10천비교차이구유통계학의의(P<0.05).Kaplan-Meier생존분석현시입원고PCT수평조여저PCT수평조환자28 d생존솔차이구유통계학의의(P<0.05).결론 입원고PCT수평적환자병정경엄중차경용역출현각충병발증포괄감염차예후불량.동태감측혈PCT수평가이작위판단단순뇌외상환자병정、감염공제급예후적유효지표지일.
Objective To study the changes of serum procalcitonin (PCT) in the patients with simple brain trauma and its relationships with injury of severity, complications and outcome of injury.Methods A total of 120 patients with simple brain trauma were evaluated in a prospective observational study.The serum levels of procalcitonin and C-reactive protein were measured 1,2,3,5,7 and 10 days after the admission.During the following ten days after admission,the clinical data of patients with simple brain trauma were recorded,and also the patients with 28-day survival were followed up.Another 30 healthy subjects were enrolled in normal group for comparison. Results In different periods after trauma,the PCT levels in brain injury patients with different degree of injury severity were significantly different ( P < 0.05 ).During the first two days after admission,there were no significant differences in serum PCT levels between non-infection group and infection group,but significant differences were found between two groups on the 3rd,5th,7th and 10th days ( P < 0.05 ).Kaplan-Meier survival analysis showed the 28 days survival between the group with high PCT level and the group with lower PCT level was statistically significant ( P <0.05 ). Conclusions Poor outcomes and complications such as infection were often occurred in simple brain trauma patients with initially high PCT.The frequent determination of serum PCT levels is a useful approach to the judgment of injury severity and proguosis in patients with simple brain trauma.