• 作者：Xavier Viñ ; as Trullen^a ; ^{xvinas@csa.cat} ; Rafael Rodrí ; guez Ló ; pez^b ; Susana Porta Pi^c ; David Salazar Terceros^a ; Enrique Macarulla Sanz^a ; Pedro Besora Canal^a ; Felix Á ; lvarez Tellez^a ; Concepció ; n Iglesias Castro^a ; Xavier Feliu Palá ; ^a
• 关键词：Procalcitonina ; Í ; ndice de Mannheim ; Peritonitis secundaria ; Unidad de cuidados intensivos
• 刊名：Cirug铆a Espa帽ola
• 出版年：2009
• 期刊代码：pca87_0009739X
• 类别：med
• 出版时间：July 2009
• 卷：86
• 期：1
• 页码：24-28
• 文件大小：123 K

Introduction

It has been shown that procalcitonin (PCT) is a good marker for sepsis as the more severe the infection the higher the plasma levels. The Mannheim peritonitis index (MPI) is very effective in assessing the prognosis of secondary peritonitis. The aim of this study is to find out whether there is any correlation between preoperative PCT levels and the postoperative MPI, as well as the prognostic value of preoperative PCT levels.

Patients and method

Prospective study of 57 patients operated on between December 2006鈥揂ugust 2008 for secondary peritonitis and classified into three groups (A: 23 patients, B: 24 patients and C: 10 patients) from lowest to highest severity of MPI. The preoperative values of procalcitonin were obtained with PCT-Q test (BRAHMS).

Results

PCT-Q was normal (<0.5 ng/ml) in 19 patients in group A, in 2 patients in group B and none in group C (p<0.001). PCT-Q between 2鈥?0 ng/ml were found in one patient in group A, 13 in group B and none in group C (p<0.001). PCT-Q >10 ng/ml were found in 10 cases in group C, 6 in group B and none in group A (p<0.001). Of the 19 patients admitted to the intensive care unit, the PCT-Q was >10 ng/ml in 15 cases vs a PCT-Q<10 mg/ml (p<0.001) in 4 cases. Seven patients died, all of them with a PCT-Q >10 mg/ml (p<0.001).

Conclusions

The correlation between preoperative PCT-Q and postoperative MPI is positive and significant. The values of PCT-Q are higher as the MPI severity increases. Values >10 ng/ml are significant for admission to the ICU and a poor clinical prognosis.