降钙素原在重症腹膜炎患者中的应用

目的:探讨降钙素原(PCT)在重症腹膜炎早期诊断和治疗效果判断中的临床意义。方法:选取2011年3月至2014年9月本院就诊的128例重症腹膜炎患者作为治疗组,并选取同期来我院体检的健康志愿者128例作为对照组,比较治疗组和对照组之间PCT水平;通过治疗后,比较好转组和恶化组患者之间PCT水平的差异。结果:治疗组患者治疗后各时段的PCT水平均显著高于对照组,差异有统计学意义(P0.05),治疗组患者的血清PCT水平在治疗后第1 d开始下降,于第1-3 d PCT水平下降速度较快,之后下降速度减缓。两组患者治疗后各时段PCT水平明显低于治疗前,且差异均具有统计学意义(P0.05)。好转组患者治疗后各时段PCT水平显著低于恶化组患者,差异具有统计学意义(P0.05),其中好转组患者血清PCT水平在治疗后第1 d开始下降,恶化组患者血清PCT水平在治疗后第1 d开始升高。与治疗前相比,好转组患者治疗后各时段PCT水平明显下降,而恶化组患者治疗后各时段PCT水平显著上升,且差异均具有统计学意义(P0.05)。结论:PCT水平不仅是重症腹膜炎的一个重要指示物,也是治疗效果的一个有效指标。

Application of Procalcitonin in the Treatment of Patients with Severe Peritonitis

ABSTRACT Objective: To investigate the clinical significance of PCT in the early diagnosis and treatment for patients with severe peritonitis. Methods: 128 patients with severe peritonitis who were treated in our hospital from March 2011 to September 2014 were selected as the treatment group, 128 healthy volunteers in our hospital for physical examination during the same period were selected as the control group. Compared the levels of PCT between treatment group and control group, and compared the levels of PCT between the patients in the improvement group and the deterioration group after treatment. Results: The level of PCT of treatment group in each period was significantly higher than that in the control group after treatment, the difference was statistically significant (P<0.05). The level of serum PCT of the treatment group began to decrease at 1st day after treatment, and the level of PCT decreased rapidly during the 1-3 days after treatment, the level of PCT decline slowed after third day. The level of PCT of two groups at each point after treatment was lower significantly than before treatment, the difference was statistically significant (P<0.05). The level of PCT of improvement group in each period was significantly lower than that in the deterioration group, the difference was statistically significant (P<0.05). The level of serum PCT of improvement group was decreased at first day after treatment, and the level of serum PCT of deterioration group was increased at first day after treatment. Compared with before treatment, the level of PCT of improvement group in each period decreased significantly, while deterioration group of patients increased significantly, the difference was statistically significant (P<0.05). Conclusion: The level of PCT is not only an important indicator of severe peritonitis,but also an indicator of treatment effect.