血清PCT与CRP和血小板对重症感染患者病情程度的评估效果研究
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摘要
目的探索血清降钙素原(PCT)、C-反应蛋白(CRP)与血小板计数(PLT)对重症感染患者病情程度的评估效果。方法选取2015年12月-2018年1月于医院接受治疗的266例重症感染患者作为研究组,并选择同期于医院就诊的242例上呼吸道感染患者为对照组。根据患者入院时APACHEⅡ评分将研究组患者分为次低危险组、低危险组、中危险组、高危险组。检测所有研究对象血液PCT、CRP、PLT指标水平,并采用Spearman分析软件分析不同病情程度与血清PCT、CRP、PLT指标的相关性。结果研究组患者PCT、CRP指标水平分别高于对照组,PLT计数低于对照组,两组比较差异均有统计学意义(P<0.05)。重症感染患者病情越严重PCT、CRP指标数值越高,PLT指标数值越低(P<0.05)。重症感染患者病情程度与PCT、CRP呈正相关关系(r=0.418,r=0.575,均P<0.05),与PLT计数呈负相关关系,(r=-0.439,P<0.05)。结论重症感染患者血清PCT、CRP、PLT较上呼吸道感染患者变化明显,且重症感染患者病情程度与血清PCT、CRP、PLT具有相关性,与APACHEⅡ评分结合具有较好的评估效果。
OBJECTIVE To explore the effect of serum procalcitonin(PCT),C-reactive protein(CRP)and platelet(PLT)counts on evaluation of illness condition of the patients with severe infection.METHODS Totally 266 patients with severe infection who were treated in the hospital from Dec 2015 to Jan 2018 were chosen as the study group,meanwhile,242 patients with upper respiratory tract infection were chosen as the control group.The enrolled patients were divided into the sub-low risk group,low risk group,medium risk group and high risk group.The levels of serum PCT,CRP and PLT of the study objects were detected,and the correlation between the illness condition and the serum PCT,CRP and PLT was analyzed by using Spearman software.RESULTS The levels of PCT and CRP of the study group were higher than those of the control group,the PLT counts of the study group were less than those of the control group,and there were significant differences between the two groups((P<0.05).The more severe the illness condition of the patients with severe infection,the higher the levels of PCT and CRP,the lower the PLT level(P<0.05).The illness condition of the patients with severe infection was positively correlated with the PCT and CRP(r=0.418,r=0.575,all P<0.05)but was negatively correlated with the PLT counts(r=-0.439,P<0.05).CONCLUSIONThe levels of serum PCT,CRP and PLT change more significantly in the patients with severe infection than in the patients with upper respiratory tract infection;the illness condition of the patients with severe infection is associated with the serum PCT,CRP and PLT,and their combination with APACHE Ⅱscore can achieve remarkable effect on evaluation of the illness condition.
OBJECTIVE To explore the effect of serum procalcitonin(PCT),C-reactive protein(CRP)and platelet(PLT)counts on evaluation of illness condition of the patients with severe infection.METHODS Totally 266 patients with severe infection who were treated in the hospital from Dec 2015 to Jan 2018 were chosen as the study group,meanwhile,242 patients with upper respiratory tract infection were chosen as the control group.The enrolled patients were divided into the sub-low risk group,low risk group,medium risk group and high risk group.The levels of serum PCT,CRP and PLT of the study objects were detected,and the correlation between the illness condition and the serum PCT,CRP and PLT was analyzed by using Spearman software.RESULTS The levels of PCT and CRP of the study group were higher than those of the control group,the PLT counts of the study group were less than those of the control group,and there were significant differences between the two groups((P<0.05).The more severe the illness condition of the patients with severe infection,the higher the levels of PCT and CRP,the lower the PLT level(P<0.05).The illness condition of the patients with severe infection was positively correlated with the PCT and CRP(r=0.418,r=0.575,all P<0.05)but was negatively correlated with the PLT counts(r=-0.439,P<0.05).CONCLUSIONThe levels of serum PCT,CRP and PLT change more significantly in the patients with severe infection than in the patients with upper respiratory tract infection;the illness condition of the patients with severe infection is associated with the serum PCT,CRP and PLT,and their combination with APACHE Ⅱscore can achieve remarkable effect on evaluation of the illness condition.
引文
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[15]杨梅雨.CD69与CRP、IL-6在小儿重症感染中的诊断价值[J].医学临床研究,2014,31(10):2039-2040.
[16]钟映玉.重症感染患者病情危重程度与血清降钙素原、C-反应蛋白及血小板的相关性分析[J].河北医药,2017,39(10):1471-1473.
[17]Shimizu T,Harada K,Akazawa S,et al.Identification of the cause of severe skin infection by Fournier transform infrared spectroscopy:a case of Fournier's gangrene caused by fish bone[J].J Dermatol,2014,41(6):547-550.
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[19]Eo KY,Kwak D,Kwon OD.Severe whipworm(Trichuris spp.)infection in the dromedary(Camelus dromedarius)[J].J Zoo Wildl Med,2014,45(1):190-192.
[20]Michael-Gayego A,Dan-Goor M,Jaffe J,et al.Characterization of sil in invasive group A and G Streptococci:antibodies against bacterial pheromone peptide SilCR result in severe infection[J].Infect Immun,2013,81(11):4121-4127.
[21]Hoeboer SH,van der Geest PJ,Nieboer D,et al.The diagnostic accuracy of procalcitonin for bacteraemia:a systematic review and meta-analysis[J].Clin Microbiol Infect,2015,21(5):474-481.
[22]Gomez-Cerquera JM,Daroca-Perez R,Baeza-Trinidad R,et al.Validity of procalcitonin for the diagnosis of bacterial infection in elderly patients[J].Enferm Infecc Microbiol Clin,2015,33(8):521-524.
[23]Yan L,Liao P,Xu LL,et al.Usefulness of procalcitonin in elderly patients with bacterial infection[J].Clin Lab,2014,60(1):139-142.
[24]Young D,Camhi S,Wu T,et al.Relationships among changes in C-reactive protein and cardiovascular disease risk factors with lifestyle interventions[J].Nutr Metab Cardiovasc Dis,2013,23(9):857-863.
[2]陈新军,叶荣,魏秀娥,等.重症感染休克患者血小板参数变化在治疗中的临床意义[J].中华医院感染学杂志,2014,24(22):5559-5561.
[3]Alharfi IM,Charyk Stewart T,Al Helali I,et al.Infection rates,fevers,and associated factors in pediatric severe traumatic brain injury[J].J Neurotrauma,2014,31(5):452-458.
[4]Lin ZQ,Guo J,Xia Q,et al.Human leukocyte antigen-DRexpression on peripheral monocytes may be an early marker for secondary infection in severe acute pancreatitis[J].Hepatogastroenterology,2013,60(128):1896-1902.
[5]方冬香,屈品均,陈玉娟,等.亚胺培南与美罗培南对重症感染患者的临床疗效及血清CRP、PCT的影响比较[J].中国生化药物杂志,2016,28(5):90-91,94.
[6]Chiu SN,Shao PL,Wang JK,et al.Severe bacterial infection in patients with heterotaxy syndrome[J].J Pediatr,2014,164(1):99-104.
[7]中华医学会重症医学分会.中国重症加强治疗病房建设与管理指南(2006)[J].中华外科杂志,2006,44(17):1156-1157.
[8]Wukich DK,Hobizal KB,Brooks MM.Severity of diabetic foot infection and rate of limb salvage[J].Foot Ankle Int,2013,34(3):351-358.
[9]Principi N,Daleno C,Esposito S.Human rhinoviruses and severe respiratory infections:is it possible to identify at-risk patients early[J].Expert Rev Anti Infect Ther,2014,12(4):423-430.
[10]朱明亮,何烁,顾达飞,等.降钙素原用于小儿重症感染的诊断价值分析[J].中国生化药物杂志,2017,29(4):419-421.
[11]李莉,温小凤,柯柳,等.血清PCT、CRP与APACHEⅡ评分联合检测对ICU老年重症感染的临床意义[J].检验医学与临床,2018,15(10):1486-1489.
[12]Babovic N,Cayci C,Carlsen BT.Cat bite infections of the hand:assessment of morbidity and predictors of severe infection[J].J Hand Surg Am,2014,39(2):286-290.
[13]Tadesse H,Tadesse K.Assessing the association of severe malaria infection and ABO blood groups in northwestern E-thiopia[J].J Vector Borne Dis,2013,50(4):292-296.
[14]袁盛伟,邓杰.CRP、PCT与APACHEⅡ评分判断ICU老年重症感染患者预后的价值[J].中国老年学杂志,2018,38(7):1655-1657.
[15]杨梅雨.CD69与CRP、IL-6在小儿重症感染中的诊断价值[J].医学临床研究,2014,31(10):2039-2040.
[16]钟映玉.重症感染患者病情危重程度与血清降钙素原、C-反应蛋白及血小板的相关性分析[J].河北医药,2017,39(10):1471-1473.
[17]Shimizu T,Harada K,Akazawa S,et al.Identification of the cause of severe skin infection by Fournier transform infrared spectroscopy:a case of Fournier's gangrene caused by fish bone[J].J Dermatol,2014,41(6):547-550.
[18]Wu C,Cheng X,Wang X,et al.Clinical and molecular characteristics of the 2009pandemic influenza H1N1infection with severe or fatal disease from 2009to 2011in Shenzhen,China[J].J Med Virol,2013,85(3):405-412.
[19]Eo KY,Kwak D,Kwon OD.Severe whipworm(Trichuris spp.)infection in the dromedary(Camelus dromedarius)[J].J Zoo Wildl Med,2014,45(1):190-192.
[20]Michael-Gayego A,Dan-Goor M,Jaffe J,et al.Characterization of sil in invasive group A and G Streptococci:antibodies against bacterial pheromone peptide SilCR result in severe infection[J].Infect Immun,2013,81(11):4121-4127.
[21]Hoeboer SH,van der Geest PJ,Nieboer D,et al.The diagnostic accuracy of procalcitonin for bacteraemia:a systematic review and meta-analysis[J].Clin Microbiol Infect,2015,21(5):474-481.
[22]Gomez-Cerquera JM,Daroca-Perez R,Baeza-Trinidad R,et al.Validity of procalcitonin for the diagnosis of bacterial infection in elderly patients[J].Enferm Infecc Microbiol Clin,2015,33(8):521-524.
[23]Yan L,Liao P,Xu LL,et al.Usefulness of procalcitonin in elderly patients with bacterial infection[J].Clin Lab,2014,60(1):139-142.
[24]Young D,Camhi S,Wu T,et al.Relationships among changes in C-reactive protein and cardiovascular disease risk factors with lifestyle interventions[J].Nutr Metab Cardiovasc Dis,2013,23(9):857-863.