【摘要】 目的探讨血降钙素原、白细胞计数和C反应蛋白对成人心脏术后早期感染的诊断价值。方法选取本院2012年1月至2014年6月行体外循环心脏手术的成人患者117例为观察组,其中术后感染患者39例为A组,术后未感染患者78例为B组,同期健康体检者117例为对照组,均行血降钙素原和C反应蛋白检测以及白细胞计数,比较各组人员不同时间点检测指标的改变情况,分析观察组手术相关指征。结果观察组术后3 d血降钙素原、白细胞计数和C反应蛋白均高于对照组。B组术毕时血降钙素原、白细胞计数和C反应蛋白均显著升高,术后1 d升至最高点,术后2 d显著下降。A组术毕时血降钙素原、白细胞计数和C反应蛋白均显著升高,术后3 d升至最高点,在术毕、术后1 d、2 d、3 d时高于B组。中度感染患者血降钙素原高于轻度感染患者。重度感染患者血降钙素原高于轻度感染患者和中度感染患者。A组手术时间、体外循环时间、阻断时间长于B组(P<0.05)。术后感染与血降钙素原、白细胞计数和C反应蛋白有明显的正相关性(P<0.05)。结论血降钙素原、白细胞计数和C反应蛋白可作为成人心脏术后早期感染的有效诊断指标。更多还原

【Abstract】 Objective To investigate diagnostic value of blood procalcitonin, white blood cell count, C reactive protein(CRP) in early infection after cardiac surgery in adults. Methods A total of 117 adult patients undergoing cardiopulmonary bypass heart operation in our hospital from October 2010 to December 2013 were selected as observation group, of which 39 with postoperative infection were enrolled as group A and 78 without postoperative infection were enrolled as group B. Meanwhile, 117 healthy persons were selected as the control group. All the people underwent serum procalcitonin detection, white blood cell count, C reactive protein detection. Changes of relevant indexes at different time points(preoperative, postoperative 1 d, postoperative 2 d, postoperative 3 d) were compared between groups. Relevant operation indications were analyzed in the observation group. Results Blood procalcitonin,white blood cell count and CRP 3 d after operation in the observation group were higher than those in the control group. Blood procalcitonin, white blood cell count and CRP at postoperative increased significantly in group B, reached the highest at postoperative 1 d, and decreased significantly at postoperative 2 d. Blood procalcitonin, white blood cell count, CRP at postoperative increased significantly in group A, reached the highest at postoperative 3 d, which were higher than group B at postoperative, postoperative 1 d, 2 d, 3 d. Serum procalcitonin in patients with moderate infection were higher than those with mild infection, and serum procalcitonin in patients with severe infection were higher than those with mild infection and moderate infection. Operation time, cardiopulmonary bypass time, blocking time in group A were significantly longer than group B(P<0.05). Postoperative infection had significant positive correlation with blood procalcitonin, white blood cell count and CRP(P<0.05). Conclusion Blood procalcitonin, white blood cell count, CRP can be used as effective indexes in the diagnosis of early infection after cardiac surgery in adults.更多还原