摘要
目的探讨血清降钙素原(PCT)、C-反应蛋白(CRP)及白细胞介素-6(IL-6)对老年重型脑外伤患者肺部感染的预测价值。方法选取2015年1月至2017年12月海南省第三人民医院收治的老年重型脑外伤患者172例,根据其是否发生肺部感染分为感染组(81例)和非感染组(91例),比较两组入院第1、3、5天血清PCT、CRP及IL-6水平变化。应用受试者工作特征(ROC)曲线分析各时间点血清PCT、CRP及IL-6水平对肺部感染的预测价值。结果感染组第3天、第5天血清PCT、CRP及IL-6水平明显高于非感染组[PCT(ng/mL):0.97±0.65 vs.0.62±0.28,2.41±1.26 vs.0.48±0.17;CRP(mg/L):88.63±15.41 vs.74.50±12.28,92.48±18.74 vs.62.38±9.51;IL-6(ng/L):85.62±22.37 vs.64.38±16.50,94.26±28.50 vs.57.30±12.48,均P﹤0.05],且感染组第3天、第5天血清PCT、CRP及IL-6水平明显高于第1天[血清PCT(ng/mL):0.97±0.65和2.41±1.26 vs.0.60±0.31,CRP(mg/L):88.63±15.41和92.48±18.74 vs.67.24±10.25,IL-6(ng/L):85.62±22.37和94.26±28.50 vs.54.83±12.16,均P﹤0.05]。ROC曲线显示,第3天血清PCT、CRP及IL-6联合预测老年重型脑外伤患者肺部感染的AUC(95% CI)为0.904(0.845~0.966)明显高于单项血清PCT第3天[0.826(0.768~0.887)]、CRP第3天[0.805(0.748~0.865)]及IL-6第3天[0.773(0.715~0.835)],其敏感度和特异度为90.6%和85.2%。结论入院第3天血清PCT、CRP及IL-6联合预测老年重型脑外伤患者肺部感染的价值最大。
Objective To investigate the predictive value of serum procalcitonin(PCT),C-reactive protein(CRP)and interleukin-6(IL-6)on lung infection in elderly patients with severe brain injury.Methods One hundred and seventy-two cases of elderly severe brain trauma treated in our hospital from January 2015 to December 2017.They were divided into infection group(81 cases)and non-infection group(91 cases)according to whether they had pulmonary infection.The changes of serum PCT,CRP and IL-6 levels in two groups on the first,third,fifth day after admission were compared.The predictive value of serum PCT,CRP and IL-6 levels in each time point for pulmonary infection was analyzed by ROC curve.Results The levels of serum PCT,CRP and IL-6 in the infected group were significantly higher than those in the non-infected group on third day and fifth day[PCT(ng/mL):0.97±0.65 vs.0.62±0.28,2.41+1.26 vs.0.48±0.17;CRP(mg/L):88.63±15.41 vs.74.50±12.28,92.48±18.74 vs.62.38±9.51;IL-6(ng/L):85.62±22.37 vs.64.38±16.50,94.26±28.50 vs.57.30±12.48,all P﹤0.05].The levels of serum PCT,CRP.and IL-6 on the third day and fifth day of infection group were significantly higher than those on the first day[PCT(ng/mL):0.97±0.65 and 2.41±1.26 vs.0.60±0.31;CRP(mg/L):88.63±15.41 and 92.48±18.74 vs.67.24±10.25;IL-6(ng/L):85.62±22.37 and 94.26±28.50 vs.54.83±12.16,all P﹤0.05].The ROC curve showed that PCT,CRP and IL-6 on the third day combined prediction of pulmonary infection in elderly patients with severe brain injury of AUC(95%CI)with 0.904(0.845-0.966)was significantly higher than PCT d3[0.826(0.768-0.887),CRP d3[0.805(0.748-0.865)and IL-6 d3[0.773(0.715-0.835),the sensitivity and the specificity were 90.6%and 85.2%.Conclusion It is of great value to combined the third day PCT,CRP and IL-6 to predict lung infection in elderly patients with severe brain injury.
作者
肖华
卓芬
黄娟娟
蔡月红
Xiao Hua;Zhuo Fen;Huang Juan-juan;Cai Yue-hong(Department of Clinical Laboratory,Third People′s Hospital of Hainan Province,Sanya 572000,China)
出处
《中国急救医学》
CAS
CSCD
北大核心
2019年第1期20-24,共5页
Chinese Journal of Critical Care Medicine
基金
海南省医药卫生科研基金项目(17A200518).
