【摘要】：目的：探討PCT、CRP等炎性標記物實驗室檢測對重癥顱腦損傷患者肺部感染早期診斷的價值。 方法：選取外傷后直接收住重癥醫(yī)學科的63例重癥顱腦損傷患者,其中男39例,女24例,年齡為14～85歲,平均年齡(40±4.25)歲。入住ICU后1h內(nèi)留取血標本,然后收集患者每日的臨床資料,記錄體溫峰值(℃)、白細胞計數(shù)(WBC)及中性粒細胞(NEU)、急性時相反應蛋白(CRP)、降鈣素原(PCT),結(jié)合微生物指標、影像檢查結(jié)果作為觀察指標列表。所有參數(shù)設置與實驗步驟均嚴格按其操作規(guī)程進行。根據(jù)最終臨床特征和實驗室檢查結(jié)果,將患者分為非感染組和感染組。所有數(shù)據(jù)以SPSS13.0統(tǒng)計軟件處理,統(tǒng)計學處理正態(tài)分布的計量資料用x±s表示,2個樣本均數(shù)比較采用兩組完全隨機化設計資料均數(shù)的t檢驗,檢驗水準α=0.05。P0.05為差異有統(tǒng)計學意義。結(jié)合指標列表探討上述指標對重癥顱腦損傷患者肺部感染早期診斷及治療的臨床意義。 結(jié)果：1.感染組血清中PCT檢測陽性率為97.3%,CRP檢測陽性率為100%,PCT、CRP含量均明顯高于非感染組,差異均具有統(tǒng)計學意義(P0.05);2.PCT、 CRP對重癥顱腦損傷患者肺部感染早期診斷靈敏度分別為76%、81%,特異度分別為69%、15%。3.聯(lián)合檢測靈敏度、特異度分別為81%、77%。 結(jié)論：PCT聯(lián)合CRP檢測陽性率及特異性高,故聯(lián)合監(jiān)測重癥顱腦損傷患者血清中PCT和CRP含量可作為ICU重癥顱腦損傷患者繼發(fā)肺部感染早期較特異和敏感指標。
[Abstract]:Objective: to investigate the value of laboratory detection of PCT,CRP and other inflammatory markers in the early diagnosis of pulmonary infection in patients with severe craniocerebral injury. Methods: a total of 63 patients with severe craniocerebral injury were enrolled in this study, including 39 males and 24 females, aged from 14 to 85 years, with an average age of (40 鹵4.25) years. Blood samples were collected within 1 hour after admission to ICU, and daily clinical data were collected to record the peak temperature (C), white blood cell count (WBC) and neutrophil (NEU), acute phase reactive protein (CRP), procalcitonin (PCT),. Combined with microbial indicators, the imaging results were used as a list of observed indicators. All parameters and experimental steps are strictly in accordance with its operating procedures. According to the final clinical features and laboratory results, the patients were divided into non-infection group and infection group. All the data were processed by SPSS13.0 statistical software, the statistical data of normal distribution were expressed by x 鹵s, and the mean of two samples were compared by using the t test of two groups of completely randomized design data mean. The difference of test level 偽 = 0.05.P0.05 was statistically significant. To explore the clinical significance of the above indexes in the early diagnosis and treatment of pulmonary infection in patients with severe craniocerebral injury. Results: 1. The positive rate of PCT detection in infected group was 97.3%. The positive rate of PCT in infected group was significantly higher than that in non-infected group (P0.05). 2. The sensitivity of PCT and CRP in the early diagnosis of pulmonary infection in patients with severe craniocerebral injury were 76 ~ 81, and the specificity were 69 ~ 15. 3 respectively. The sensitivity and specificity of combined detection were 81% and 77%, respectively. Conclusion: the positive rate and specificity of PCT combined with CRP are high, so the combined monitoring of PCT and CRP in serum of patients with severe craniocerebral injury can be used as a specific and sensitive index in the early stage of secondary pulmonary infection in patients with ICU severe craniocerebral injury.
【學位授予單位】：青島大學
【學位級別】：碩士
【學位授予年份】：2014
【分類號】：R651.15

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