临床普外科电子杂志
臨床普外科電子雜誌
림상보외과전자잡지
Journal of General Surgery for Clinicians (Electronic Version)
2014年
2期
36-39
,共4页
重症急性胰腺炎%感染%降钙素原%内毒素%C-反应蛋白
重癥急性胰腺炎%感染%降鈣素原%內毒素%C-反應蛋白
중증급성이선염%감염%강개소원%내독소%C-반응단백
Sever acute pancreatitis%infection%procalcitonin%endotoxin%C-reaction protein
目的：比较血清降钙素原（procalcitonin ，PCT）、内毒素、C-反应蛋白（C-reaction protein,CRP）水平测定在急性重症胰腺炎(severe acute pancreatitis，SAP)合并感染患者中的早期诊断价值。方法回顾性分析SAP患者80例，根据病人是否存在感染分为感染组(53例)和非感染组(27例)，检测两组患者入院24小时、48小时的PCT、内毒素、CRP水平，同时观察患者的住院天数和住院费用。结果比较入院24小时两组病人的数据，感染组患者血清中PCT水平明显增高，与非感染组比较差异具有统计学意义(P＜0.05)，内毒素和CRP水平增高，但与非感染组比较差异无统计学意义(P＞0.05)；比较入院48小时两组数据，感染组PCT、内毒素、CRP均较非感染组明显升高，差异具有统计学意义(P＜0.05)；对入院24小时诊断为SAP合并感染者，PCT的敏感度为84.91%(45/53)，特异度为92.59%(25/27)，内毒素的敏感度为73.59%(39/53)，特异度为74.07%(20/27)，CRP的敏感度为67.93%(36/53)，特异度为66.67%(18/27)。入院4小时内SAP病人合并感染PCT水平升高者住院天数明显延长，住院费用增加。结论对SAP患者进行血清PCT水平的测定，有助于对SAP病人的病情严重程度进行评估，判断SAP早期合并感染具有重要的临床价值，对SAP的诊断和治疗具有重要的临床指导意义。
目的：比較血清降鈣素原（procalcitonin ，PCT）、內毒素、C-反應蛋白（C-reaction protein,CRP）水平測定在急性重癥胰腺炎(severe acute pancreatitis，SAP)閤併感染患者中的早期診斷價值。方法迴顧性分析SAP患者80例，根據病人是否存在感染分為感染組(53例)和非感染組(27例)，檢測兩組患者入院24小時、48小時的PCT、內毒素、CRP水平，同時觀察患者的住院天數和住院費用。結果比較入院24小時兩組病人的數據，感染組患者血清中PCT水平明顯增高，與非感染組比較差異具有統計學意義(P＜0.05)，內毒素和CRP水平增高，但與非感染組比較差異無統計學意義(P＞0.05)；比較入院48小時兩組數據，感染組PCT、內毒素、CRP均較非感染組明顯升高，差異具有統計學意義(P＜0.05)；對入院24小時診斷為SAP閤併感染者，PCT的敏感度為84.91%(45/53)，特異度為92.59%(25/27)，內毒素的敏感度為73.59%(39/53)，特異度為74.07%(20/27)，CRP的敏感度為67.93%(36/53)，特異度為66.67%(18/27)。入院4小時內SAP病人閤併感染PCT水平升高者住院天數明顯延長，住院費用增加。結論對SAP患者進行血清PCT水平的測定，有助于對SAP病人的病情嚴重程度進行評估，判斷SAP早期閤併感染具有重要的臨床價值，對SAP的診斷和治療具有重要的臨床指導意義。
목적：비교혈청강개소원（procalcitonin ，PCT）、내독소、C-반응단백（C-reaction protein,CRP）수평측정재급성중증이선염(severe acute pancreatitis，SAP)합병감염환자중적조기진단개치。방법회고성분석SAP환자80례，근거병인시부존재감염분위감염조(53례)화비감염조(27례)，검측량조환자입원24소시、48소시적PCT、내독소、CRP수평，동시관찰환자적주원천수화주원비용。결과비교입원24소시량조병인적수거，감염조환자혈청중PCT수평명현증고，여비감염조비교차이구유통계학의의(P＜0.05)，내독소화CRP수평증고，단여비감염조비교차이무통계학의의(P＞0.05)；비교입원48소시량조수거，감염조PCT、내독소、CRP균교비감염조명현승고，차이구유통계학의의(P＜0.05)；대입원24소시진단위SAP합병감염자，PCT적민감도위84.91%(45/53)，특이도위92.59%(25/27)，내독소적민감도위73.59%(39/53)，특이도위74.07%(20/27)，CRP적민감도위67.93%(36/53)，특이도위66.67%(18/27)。입원4소시내SAP병인합병감염PCT수평승고자주원천수명현연장，주원비용증가。결론대SAP환자진행혈청PCT수평적측정，유조우대SAP병인적병정엄중정도진행평고，판단SAP조기합병감염구유중요적림상개치，대SAP적진단화치료구유중요적림상지도의의。
Objective To investigate the clinical value of procalcitonin(PCT) determination in the patients with severe acute pancreatitis(SAP) complicated with infection.Methods Eighty patients with SAP were reviewed and eighty patients with SAP were randomly divided into 2 groups , infection group and non-infection group according to the diagnosis criteria of severe acute pancreatitis complicated with infection. 53 patients with severe acute pancreatitis were in infection group and 27 patients were in non-infection group.The PCT level , endotoxin level and C-reaction protein(CRP) level of the patients were determined after 24hr and 48hr during the hospital in these two groups. The mean hospital stay and hospital costs of the patients with SAP were also observed.Results There were signiifcant difference(P<0.05) in the PCT level and endotoxin level between the patients of infection group and the patients of non-infection group. The level of PCT had no correlation with the level of CRP and endotoxin between the patients of infection group and the patients of non-infection group. The sensitivity and speciifcity of PCT were 84.91% and 92.59% respectively in the patients of SAP with infection, the sensitivity and speciifcity of endotoxin were73.59% and 74.07% respectively in the patients of SAP with infection, the sensitivity and specificity of CRP were 67.93% and 66.67% respectively in patients of SAP with infection. The SAP patients with infection with high PCT level would have long hospital stay and much high hospital costs.Conclusion It is helpful to predict early infection and evaluated the risk factors and the prognosis of the SAP patients with complicated with infection to monitoring of the PCT level.This examination would have an obvious clinical value in diagnosis and treatment for the patients with severe acute pancreatitis complicated with infection.
