摘要
目的探讨腹部外伤手术患者术后血清白细胞介素-6(IL-6)、降钙素原(PCT)、C-反应蛋白(CRP)与并发感染的相关性。方法选择2014年2月-2017年2月医院收治的256例腹部外伤手术患者作为研究对象,根据病原学检测结果确诊为感染设为感染组30例,未感染组226例,比较两组患者手术前、术后6、12、24、72、168、240h的血清IL-6、PCT、CRP水平变化;分析不同时间段血清IL-6、PCT、CRP阳性率与感染率的相关性。结果腹部外伤患者术后10d内发生感染30例,感染率11.72%。感染组患者术后各时间段血清PCT、CRP明显较术前升高(P<0.05),且在术后12、24、72、168hPCT、CRP明显高于未感染组患者(P<0.05)。两组患者术后各时间点IL-6水平明显高于术前,但感染组患者上述时间点IL-6均明显高于未感染组(P<0.05);术后12、24、72、168、240hPCT与病原学检测诊断感染结果的Pearson相关性系数rn均>0.7;血清IL-6在72h、168h、240h相关系数均>0.5;血清CRP 12、24、72、168、240h相关系数均>0.6。结论腹部外伤患者病情复杂,创伤对患者的血清IL-6影响较大,其与感染的相关性系数在不同时间内差异较大,PCT、CRP在不同时间内和病原学检测感染阳性相关性较好。
OBJECTIVE To analyze the correlation between postoperative serum interleukin-6（LI-6）,procalcitonin（PCT）and C-reactive protein（CRP）levels and infections in patients with abdominal trauma.METHODS A total of 256 cases of abdominal trauma patients from Feb.2014 to Feb.2017 admitted to the hospital were selected as the research objects,and were divided into infection group（30 cases）and non-infection group（226 cases）according to the results of pathogenic detection.The level changes of serum IL-6,PCT and CRP before operation and at 6,12,24,72,168,and 240 hafter operation were compared.The correlation of serum IL-6,PCT and CRP positive rate with infection rate in different time periods was analyzed.RESULTS There were 30 cases of infections in patients with abdominal trauma,and the 10 dinfection rate was 11.72%.The serum levels of PCT and CRP in infection group were significantly higher than those before operation（P〈0.05）,and the serum levels of PCT and CRP at 12 h,24 h,72 h,and 168 hafter operation were significantly higher than those in non-infection group（P〈0.05）.The levels of IL-6 at diffevent time points after operation of the two groups of patients were significantly higher than those before operation,and the IL-6 levels of infection group at the above time points were significantly higher than those of non-infection group（P〈0.05）.Pearson correlation coefficients（rn）of PCT level and pathogenic detection results of diagnosis of infection at 12 h,24 h,72 h,168 h,and 240 hafter operation were all greater than 0.7,coefficients of serum IL-6 at 72 h,168 h,and 240 hwere all greater than 0.5,and coefficients of serum CRP at 12 h,24 h,72 h,168 h,and 240 hwere all greater than 0.6.CONCLUSION Abdominal trauma patients have complex disease condition,trauma has great influence on the serum IL-6,and the correlation coefficients of serum IL-6 and infection at different time are different,and PCT and CRP and pathogenic detection positive results has good correlation at different time.
作者
韩杰
薛玉龙
汪传一
杨征宇
陈志亚
徐彬博
HAN Jie XUE Yu-long WANG Chuan-yi YANG Zheng-yu CHEN Zhi-ya XU Bin-bo(Luoyang Dongfang Hospital, Luoyang, Henan 471003, China)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2017年第20期4708-4711,共4页
Chinese Journal of Nosocomiology
