摘要
目的:探讨降钙素原(procalcitonin,PCT)、C-反应蛋白(C-reactive protein,CRP)和白细胞计数(white blood cell count,WBC)对腹腔肿瘤患者术后并发腹腔感染(intra-abdominal infection,IAI)的诊断价值。方法:选取2017年1月至2021年12月期间在攀枝花市第二人民医院因腹腔肿瘤术后转入重症监护病房(intensive care unit,ICU)的住院患者78例作为研究对象,根据是否合并腹腔感染分为IAI组(43例)和对照组(35例),所有患者在转入ICU治疗后的第1d、2d、3d分别检测PCT(电化学发光法)、CRP(免疫比浊法)、WBC(流式细胞术)水平,采用受试者工作特征(receiver operator characteristic,ROC)曲线评价PCT、CRP、WBC对腹腔肿瘤术后患者并发腹腔感染的诊断价值。结果:IAI组患者的男性患者占比、APACHEⅡ评分、SOFA评分均高于对照组,差异均有统计学意义(均P<0.05)。两组患者的PCT在治疗1 d时升高,治疗后2 d、3 d逐渐降低,时间效应有统计学意义(F时间=39.578,P<0.001),两组患者的PCT总体水平存在差异,IAI组高于对照组,组间效应有统计学意义(F组间=89.257,P<0.001);两组患者的CRP在治疗后1 d、2 d时逐渐升高,在治疗3 d后逐渐降低,时间效应有统计学意义(F时间=22.987,P<0.001),两组患者的CRP总体水平存在差异,IAI组高于对照组,组间效应有统计学意义(F组间=32.567,P<0.001);IAI组WBC水平在治疗1 d后最高,治疗2 d、3 d逐渐降低,对照组WBC水平则呈持续下降趋势,时间效应有统计学意义(F时间=18.725,P<0.001),两组患者的WBC总体水平存在差异,IAI组高于对照组,组间效应有统计学意义(F组间=25.789,P<0.001)。PCT、CRP和WBC的最佳截断值分别为0.13μg/L、78.85 mg/L和14.55×10^(9)/L,PCT诊断价值的曲线下面积最高为0.701。结论:PCT对腹腔肿瘤术后并发IAI的诊断价值优于CRP和WBC,其具有较高的特异度,但灵敏度低于CRP,针对肿瘤术后患者的感染性疾病早期诊断可以利用PCT联合CRP进行辅助诊断。
Objective:To evaluate the values of procalcitonin(PCT),C-reactive protein(CRP) and white blood cell count(WBC) in the diagnosis of postoperative intra-abdominal infection(IAI) in patients with abdominal tumors.Methods:78 inpatients transferred to intensive care unit(ICU) after abdominal cancer surgery in the Second People’s Hospital of Panzhihua from January 2017 to December 2021were selected as the research objects.Patients with or without IAI were assigned to IAI group(n=43) and the control group(n=35).PCT(by electrochemiluminescence),CRP(by immunoturbidimetric assay) and WBC(by flow cytometry) were detected on 1,2 and 3 days after being transferred to ICU.Receiver operator characteristic curve was used to evaluate the diagnostic value of PCT,CRP and WBC in patients with IAI after abdominal tumor surgery.Results:The proportion of male patients,APACHE Ⅱ score and SOFA score in IAI group were significantly higher than those in the control group(all P<0.05).PCT in both groups increased on the first day of treatment and gradually decreased on second and third days after treatment,and the differences were statistically significant(F_(time)=39.578,P<0.001).PCT in IAI group was significantly higher than that in the control group(F_(group)=89.257,P<0.001).CRP in both groups increased gradually at first and second(lays aftet treatment and decreased gradually at the third day after treatment,and the differences were statistically significant(F_(time)=22.987,P<0.001).CRP in IAI group was significantly higher than that in the control group(F_(group)=32.567,P<0.001).WBC in IAI group peaked after 1 day of treatment,and gradually decreased 2 and 3 days after treatment;WBC in the control group showed a downward trend;and the differences were statistically significant(F_(time)=18.725,P<0.001).WBC in IAI group was significantly higher than that in the control group(F_(group)=25.789,P<0.001).The cut-off values of PCT,CRP and WBC were 0.13μg/L,78.85 mg/L and 14.55×10^(9)/L.The highest AUC of PCT was 0.701.Conclusion:The diagnostic value of PCT for IAI after abdominal tumor surgery is better than those of CRP and WBC.Its specificity is high,but its sensitivity is lower than CRP.PCT and CRP can serve as auxiliary diagnosis of infectious diseases after tumor surgery.
作者
王丽
刘丽
杨冬
李强
Wang Li;Liu Li;Yang Dong;Li Qiang(Intensive Care Unit,the Second People's Hospital of Panzhihua,Panzhihua 617067,Sichuan,China)
出处
《肿瘤预防与治疗》
2022年第11期1009-1014,共6页
Journal of Cancer Control And Treatment
关键词
降钙素原
C-反应蛋白
白细胞计数
腹腔感染
诊断价值
Procalcitonin
C-reactive protein
White blood cell count
Intra-abdominal infection
Diagnostic value
作者简介
通讯作者:李强,E-mail:826513138@qq.com。
