联合监测PCT、CRP、PLT应用于神经外科ICU重症感染患者预后判断的临床价值-现代医学

联合监测PCT、CRP、PLT应用于神经外科ICU重症感染患者预后判断的临床价值

单位：首都医科大学宣武医院神经外科, 北京 100053

分类号：R473.5

出版年·卷·期（页码）：2017·36·第四期（475-478）

摘要：

目的：探讨血清降钙素原（procalcitonin，PCT）、C反应蛋白（C-reactive protein，CRP）及血小板（blood platelet，PLT）与神经外科ICU重症感染患者预后的关系，为临床应用提供依据。方法：选取120例2013年7月至2015年7月间我院神经外科收治的ICU重症感染患者作为研究对象，所有患者均在进入ICU病发24 h内使用序贯器官衰竭估计（SOFA）评分及急性生理学与慢性健康状况Ⅱ（APACHEⅡ）评分进行评估。采集患者空腹静脉血5 ml，分析患者PLT水平；使用电化学发光法检测患者血清中CRP及PCT水平。将所有患者依照预后效果分为预后良好组和预后不良组，分析两组患者PCT、CRP、PLT指标差异。结果：预后良好组患者血清CRP及PCT水平阳性者比例显著低于预后不良组（P<0.05），预后良好组患者血清CRP及PCT水平均明显低于预后不良组，差异有统计学意义（P<0.05）；预后良好组患者PLT阳性者比例显著低于预后不良组（P<0.05），预后良好组患者PLT水平显著高于预后不良组（P<0.05）。预后良好组患者APACHEⅡ及SOFA评分均显著低于预后不良组（P<0.05）；PCT、CRP与SOFA呈正相关（r=0.683，P=0.000；r=0.602，P=0.046），与APACHEⅡ呈正相关（r=0.751，P=0.001；r=0.694，P=0.022）；PLT与SOFA、APACHEⅡ呈负相关（r=-0.612，P=0.023；r=-0.632，P=0.007）。结论：联合检测ICU重症感染患者血清中PCT和CRP水平及PLT计数，可评估患者病情，作为患者预后判断的依据之一。

Objective: To study the relationship between serum procalcitonin(PCT), C-reactive protein(CRP) and blood platelet(PLT) and prognosis of patients with severe ICU infection in the department of neurosurgery, and to provide the basis for clinical application.Methods: Select 120 neurosurgery infection patients from July 2013 to July 2015 as the object of study. Use the sequential organ failure assessment(SOFA) and chronic health score Ⅱ and acute physiology score(APACHE Ⅱ) to assess the patients within 24 h. Collected 5 ml venous blood and analyzed the level of PLT. Use Electrochemical luminescence to detect the levels of CRP and PCT. According to the prognosis thepatients were divided into good prognosis group and poor prognosis group. Analyzed the differences of PCT, CRP and PLT between the two groups.Results: Good prognosis group's CRP and PCT positive proportion were significantly lower than poor prognosis group(P<0.05), and serum CRP and PCT levels were significantly lower than the poor prognosis group(P<0.05); good prognosis group's PLT positive proportionwas significantly lower than the poor prognosis group(P<0.05), and PLT level ofpatients in good prognosis group was significantly higher than the poor prognosis group(P<0.05). Good prognosis group's APACHE Ⅱ and SOFA scores were significantly lower than the poor prognosis group(P<0.05);PCT and CRP were positively correlated with SOFA and APACHE(r=0.683, P=0.000; r=0.602, P=0.046; r=0.751, P=0.001; r=0.694, P=0.022); PLT was negatively correlated with SOFA, APACHE Ⅱ(r=-0.612, P=0.023; r=-0.632, P=0.007).Conclusion: Detecting CRP combined with PCT and PLT count can assess the patient's condition, and can be used to judge the prognosis.

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