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降钙素原对胃部手术后感染的诊断价值

  • 摘要: 目的:通过比较白细胞计数(white blood cell count,WBC)、C反映蛋白(C reactive protein,CRP)和降钙素原(procalcitonin,PCT)在胃部手术后发生感染患者血中的表达水平,分析PCT对胃部手术后伴发感染的诊断能力。方法:选择2013年1月至2016年6月于上海市第一人民医院宝山分院普通外科接受胃部手术的患者113例,分为感染组(n=45)与未感染组(n=68)。比较术后第1、3、7天的WBC、CRP、PCT水平;进一步对WBC、CRP、PCT对胃部手术后感染的诊断价值进行受试者工作特征曲线(ROC)分析。结果:在胃部手术后第1、3、7天,感染组患者WBC、CRP、PCT的表达水平显著高于未感染组,差异有统计学意义(P<0.05)。WBC、CRP、PCT在胃部手术后第1天诊断术后感染的曲线下面积(AUC)分别为0.748、0.708、0.841;WBC、CRP和PCT在胃部术后第3天诊断术后感染的AUC分别为0.796、0.811、0.826;WBC、CRP和PCT在术后第7天诊断术后感染的AUC分别为0.784、0.781、0.802。结论:PCT对胃部术后感染的诊断能力高于WBC和CRP,与WBC、CRP相辅相成,综合参考可辅助诊断胃部手术后是否发生感染。

     

    Abstract: Objective:To analyze the diagnostic ability of procalcitonin (PCT) for postoperative infection after gastric surgery by comparing the white blood cell count (WBC), C reactive protein (CRP) and PCT expression level in blood of patients with infection after gastric surgery. Methods:113 patients who underwent gastric surgery in General Surgery Departmentfrom January 2013 to June 2016 were selected, and divided into the postoperative infected group (n=45) and the postoperative uninfected group (n=68). The expression levels of WBC, CRP and PCT were compared at the first, third and seventh days after gastric surgery, and then the receiver operating characteristic curve (ROC) was used to analyze the value of WBC, CRP and PCT in the diagnosis of postoperative gastric infection. Results:The expression levels of WBC, CRP and PCT in the infected group were significantly higher than those in the uninfected group at first, third and seventh days after operation, and the differences were statistically significant (P<0.05). On the first day after gastric surgery, the ROC analysis to diagnose postoperative infection showed that the AUC of WBC, CRP and PCT were 0.748, 0.708, and 0.841, respectively. On the third day after gastric surgery, the ROC analysis showed that the AUC of WBC, CRP and PCT were 0.796, 0.811 and 0.826, respectively. On the seventh day after gastric surgery, the ROC analysis showed that the AUC of WBC, CRP and PCT were 0.784, 0.781, and 0.802, respectively. Conclusions:PCT is better than WBC and CRP in the diagnosis of postoperative gastric infection. PCT, WBC and CRP can supplement each other to provide comprehensive reference for the diagnosis of gastric infection after surgery.

     

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