CAJ | 학술논문

目的探讨慢加急性肝衰竭(ACLF)患者血清降钙素原(PCT)水平的变化及其临床意义.方法选择ACLF患者123例,分别检测入院当天PCT、C-反应蛋白(CRP)、白细胞(WBC)及入院1周及出院前PCT水平,并进行MELD-Na评分.结果 ①入院当天感染组PCT值明显高于无感染组(P＜0.05),各组入院当天与1周及出院前PCT值比较差异均有统计学意义(P＜0.05);②血清PCT对感染诊断的敏感性为(95.23％,60/63),特异性为(100％,60/60),敏感性及特异性均高于WBC及CRP(P ＜0.01);③死亡组患者血清PCT阳性率、血清PCT水平均高于存活组(P＜0.05);MELD-Na评分＞30分组患者血清PCT水平高于MELD-Na评分＜30分组(P＜0.05).结论血清PCT测定对慢加急性肝衰竭并发感染早期诊断及判断预后具有重要意义.
목적 탐토만가급성간쇠갈(ACLF)환자혈청강개소원(PCT)수평적변화급기림상의의.방법 선택ACLF환자123례,분별검측입원당천PCT、C-반응단백(CRP)、백세포(WBC)급입원1주급출원전PCT수평,병진행MELD-Na평분.결과 ①입원당천감염조PCT치명현고우무감염조(P＜0.05),각조입원당천여1주급출원전PCT치비교차이균유통계학의의(P＜0.05);②혈청PCT대감염진단적민감성위(95.23％,60/63),특이성위(100％,60/60),민감성급특이성균고우WBC급CRP(P ＜0.01);③사망조환자혈청PCT양성솔、혈청PCT수평균고우존활조(P＜0.05);MELD-Na평분＞30분조환자혈청PCT수평고우MELD-Na평분＜30분조(P＜0.05).결론 혈청PCT측정대만가급성간쇠갈병발감염조기진단급판단예후구유중요의의.
Objective To investigate the changes and the clinical significance of serum procalcitonin (PCT) in patients with acute-on-chronic liver failure (ACLF).Methods The 123 patients with ACLF were analyzed.Regisiter the MELD-Na score and measure the levels of PCT,WBC and CRP of the first day,and measure the levels of the PCT of the seven day and the last day in hospital.Results ① PCT levels in bacterial group were higher than in non-bacterial infection group (P ＜ 0.05),PCT levels at first of admission was higher than that on the seventh day and that on the last day in hospital in all three groups (P ＜ 0.05).②The sensitivity (60/63) for the specificity of PCT was 95.23 ％ for the diagnosis of patients with bacterial peritonitis.The specificity (60/60) was 100％.They were better than WBC and CRP.③Patients in death group had a higher positive rate and a higher value of PCT than those in survival group(P ＜ 0.05).Patients in MELD-Na score ＞ 30 group had a higher PCT level than those in MELD-Na score ＜ 30 group (P ＜ 0.05).Conclusions The value of PCT may be helpful in predicting the severity of the illness and prognosis in patients with ACLF.