摘要
目的:动态监测血浆降钙素原(Procalcitonin,PCT)对急性胰腺炎(AP)患者继发感染的诊断和治疗指导价值。方法:68例AP患者,其中非细菌感染组19例(A组)、细菌感染组49例(B组);细菌感染组分重度脓毒血症(B1组)16例、非重度脓毒血症(B2组)33例。分别于第1、7、14d测定血浆PCT含量,比较各组间PCT的差别。结果:第1d所有感染组PCT均高于非感染组,但只有重度脓毒血症(B1组)有统计学显著意义(P<0.01);第7d感染组患者的PCT值均明显高于非感染组(P<0.01),且B1组的血浆PCT值明显高于B2组(P<0.05);当血浆PCT>2ng/ml时,脓毒血症发生率明显增高(P<0.01);第14dB1组仍明显高于其他组,AP感染控制后PCT很快降到接近正常,PCT持续高者预后差。结论:PCT是AP继发感染较好的诊断和观察指标,对指导抗生素的应用有较好的临床价值。
Objective： To evaluate the diagnostic and therapeutic value of procalcitonin in acute pancreatitis complicated with infection. Methods： Of the enrolled 68 AP patients , 19 ones did not develop infection（group A） and the other 49 ones developed infection （group B）.Group B were divided into severe sepsis group （group B1,n= 16） and mild sepsis group （group B2,n=33）. The level of PCT was measured on lst,7th、14th day and compared among all groups. Results： Serum PCT level in patients with infection was higher than that in the patients without infection on the first day, but only severe sepsis group was significant（P〈0.01）. On the 7th day, serum PCT level in patients with infection was obviously higher than that in patients without infection （P〈0.01）, and PCT in group B 1 was significantly higher than in group B2（P〈0.05）.The incidence of pyemia is dramatically rising if PCT level exceeds 2ng/ml. The PCT level in group B1 was higher than in all other groups on the 14th day,and which was dropped approximatiely to normal when complicated infection was controlled. It suggested that prognosis was bad when serum PCT level advanced continually. Conclusion： The level of serun. PCT may be useful to identify the AP patients who develop infection, which is helpful to guide antibiotic therapy.
出处
《泸州医学院学报》
2009年第1期31-32,35,共3页
Journal of Luzhou Medical College
