降钙素原、血沉、C反应蛋白对ICU颅脑术后患者颅内感染的诊断价值

Diagnostic value of procalcitonin, erythrocyte sedimentation rate, and Creactive protein in intracranial infection after craniocerebral surgery in patients in intensive care unit

摘要:

目的 探讨血清降钙素原（PCT）、血沉（ESR）、C反应蛋白（CRP）对重症监护病房（ICU）颅脑术后患者颅内感染的诊断价值和临床意义。方法选自2014年6月—2016年1月某院ICU收治的颅脑术后颅内感染患者21例作为感染组，同期颅脑术后未出现颅内感染的患者42例作为对照组。检测两组患者PCT、ESR、CRP水平，并进行统计分析。结果感染组和对照组在年龄、性别、平均体重质量指数、颅脑手术疾病种类及术后留置引流管方面比较，差异均无统计学意义（均P＞0.05）。感染组血清PCT、ESR、CRP升高的患者分别占95.24%、80.95%、90.48%；对照组血清PCT、ESR、CRP升高的患者分别占4.76%、14.29%、4.76%；两组血清PCT、ESR、CRP平均浓度分别与对照组比较，差异均具有统计学意义（均P＜0.05）。PCT、ESR、CRP及PCT+ESR+CRP在诊断ICU颅脑术后患者颅内感染的敏感性分别为95.24%、80.95%、90.47%和95.61%；特异性分别为95.23%、85.71%、95.23%和89.37%。结论PCT、ESR及CRP联合检测有助于ICU颅脑术后患者颅内感染的诊断，对及时早期合理应用抗菌药物有重要的指导意义。

Abstract:

ObjectiveTo explore the diagnostic value and clinical significance of serum procalcitonin (PCT), erythrocyte sedimentation rate(ESR), and Creactive protein(CRP) in intracranial infection after craniocerebral surgery in patients in intensive care unit(ICU). Methods21 patients who were admitted to the ICU in a hospital between June 2011 and January 2016 were as infection group, 42 patients without intracranial infection after craniocerebral surgery during the same period were as control group. Levels of PCT, ESR, and CRP in two groups were detected and analyzed statistically. ResultsDifferences in age, gender, average body mass index, types of craniocerebral diseases, and postoperative indwelling drainage between infection group and control group were all not statistically significant (all P>0.05). Patients with elevated serum PCT, ESR, and CRP in infection group accounted for 95.24%, 80.95% and 90.48% respectively, in control group were 4.76%, 14.29%, and 4.76% respectively；the average concentrations of serum PCT, ESR, and CRP between two groups were compared respectively, differences were all significant(all P<0.05). The sensitivity of PCT, ESR, CRP, and PCT+ESR+CRP in the diagnosis of intracranial infection after craniocerebral surgery in ICU patients were 95.24%, 80.95%, 90.47%, and 95.61% respectively; specificity were 95.23%, 85.71%, 95.23%, and 89.37% respectively. ConclusionThe combined detection of PCT, ESR, and CRP is helpful for the diagnosis of intracranial infection after craniocerebral surgery in ICU patients, it has important guiding significance for the rational use of antimicrobial agents in early stage.