[1]朱 超,安小红.血清PCT和Presepsin水平检测在脊柱疾病术后早期感染中的应用价值[J].现代检验医学杂志,2019,34(03):91-95.[doi:10.3969/j.issn.1671-7414.2019.03.022]
　ZHU Chao,AN Xiao-hong.Application Value of Serum PCT and Resepsinin Early Infection after Spinal Surgery[J].Journal of Modern Laboratory Medicine,2019,34(03):91-95.[doi:10.3969/j.issn.1671-7414.2019.03.022]
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血清PCT和Presepsin水平检测在脊柱疾病术后早期感染中的应用价值()
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《现代检验医学杂志》[ISSN:/CN:]

卷:
第34卷
期数:
2019年03期
页码:
91-95
栏目:
论著
出版日期:
2019-06-20

文章信息/Info

Title:
Application Value of Serum PCT and Resepsinin Early Infection after Spinal Surgery
文章编号:
1671-7414(2019)03-091-05
作者:
朱 超1; 安小红2
(1.陕西中医药大学附属医院骨三科,陕西咸阳 712000; 2.陕西省渭南市蒲城县医院检验科,陕西渭南 715500)
Author(s):
ZHU Chao1; AN Xiao-hong2
(1.Department of Orthopedics,Affiliated Hospital of TraditionalChinese Medicine University of Shaanxi,Shaanxi Xianyang 712000,China; 2.Departmentof Clinical Laboratory,Pucheng County Hospital of Weinan City,Shaanxi Weinan 715500,China)
关键词:
脊柱疾病;  术后早期感染;  降钙素原;  Presepsin;  C-反应蛋白
分类号:
R681.5; R446.11
DOI:
10.3969/j.issn.1671-7414.2019.03.022
文献标志码:
A
摘要:
目的 探讨血清降钙素原(procalcitonin,PCT)和可溶性白细胞分化抗原14亚型(presepsin,sCD14-ST)在脊柱疾病术后早期感染中的应用价值。方法 收集2017年12月～2018年12月期间在陕西中医药大学附属医院和蒲城县医院实施脊柱开放手术的490例患者的临床资料进行回顾性分析,所有患者均经影像学检查确诊。依据术后是否发生感染分为术前组(490例)、感染组(34例)和非感染组(456例)。所有患者分别于术前和术后第1天采集血液,血清PCT和Presepsin水平采用电化学发光免疫分析法检测; C-反应蛋白(C-reactive protein,CRP)水平采用免疫散射比浊法检测。比较分析以上指标的变化与脊柱术后感染的关系。建立受试者工作特征(receiver operatingcharacteristic,ROC)曲线评价PCT和Presepsin对脊柱术后早期感染的应用价值,并计算出两指标的最佳临界值。结果 术前组、未感染组和感染组血清PCT,CRP和Presepsin水平分别为0.11±0.03,0.51±0.07和1.49±0.13 ng/ml; 2.13±1.39,12.37±9.27和59.12±32.79 mg/L和122.13±7.26,167.59±11.38和679.39±39.17 pg/ml。单因素方差分析显示,感染组和未感染组中PCT,CRP和Presepsin水平显著高于术前组,感染组三指标的水平显著高于未感染组,差异均有统计学意义(F=59.393,72.336,97.296,均P=0.000)。相关性分析显示,感染组PCT和Presepsin 水平具有正相关性(r2=0.837,P<0.01); 两指标分别与CRP水平(r2=0.819,0.816,P<0.01)和手术持续时间(Operation duration,OD,r2=0.859,0.805,P<0.01)也呈正相关性。ROC曲线分析显示PCT的曲线下面积为0.817,95%CI:0.72～0.91,P=0.000,Presepsin的曲线下面积为0.828,95%CI:0.73～0.93,P=0.000。PCT和Presepsin的最佳临界值分别是0.63 ng/ml和259.27 pg/ml,对应的灵敏度及特异度分别为69.5%,94.7%和78.9%,91.8%。结论 检测血清PCT和Presepsin水平可以早期诊断脊柱疾病术后感染,有效地评估患者预后。
Abstract:
Objective To evaluate the value of serum PCT and presepsin in early infection after spinal diseases.Methods A retrospective analysis was made of 490 patients who underwent open spinal surgery in the Affiliated Hospital of Traditional Chinese Medicine Universityof Shaanxi and Pucheng County Hospital from December 2017 to December 2018.Allpatients were confirmed by imaging examination.The patients were divided into preoperative group(490 cases),infection group(34 cases)and non-infection group(456 cases)according to whether infection occurred after operation.All patients were collected blood before operation and on the first day after operation.Serumal levels PCT and Presepsin were detected by electrochemiluminescence immunoassay,and CRP levels were detected by immunoscattering turbidimetry.The relationships between the above indicators and early infection after spinal surgerywere compared and analyzed.The diagnostic value of PCT and Presepsin for earlyinfection was evaluated by ROC curve,and the optimal threshold value of theseindexes was calculated.Results The serumal levels of PCT,CRP and presepsin in the preoperative group,the uninfected group and the infected group were 0.11±0.03,0.51±0.07 and 1.49±0.13 ng/ml; 2.13±1.39,12.37±9.27 and 59.12±32.79 mg/L and 122.13±7.26,177.59±11.38 and 679.39±39.17 pg/ml,respectively.Univariate analysis of variance showed that the levels of PCT,CRP and Presepsin in infected and uninfected groups were significantly higher than those in preoperative group,while the levels of them in infected group were significantly higher than those in uninfected group(F=59.393,72.336,97.296,all P=0.000).The levels of PCT and Presepsin were positively correlated(r2=0.837,P<0.01).The two indexes were positively correlated with CRP levels(r2=0.819,0.816,P<0.01)and operation duration(r2=0.859,0.805,P<0.01).ROC analysis showed that the areaunder the curve of PCT was 0.817,95%CI:0.72～0.91,P=0.000,and the area under the curve of Presepsin was 0.828,95%CI:0.73～0.93,P=0.000.The optimal limits of PCT and Presepsin were 0.63 ng/ml and 259.27 pg/ml,respectively,corresponding to sensitivity and specificity(69.5%,94.7% and 78.9%,91.8%).Conclusion Detection of serumal levels ofPCT and Presepsin can be used for early diagnosis of post-operative infection of spinal diseases and for effective evaluation of the prognosis of patients.

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备注/Memo

备注/Memo:
作者简介:朱 超(1975-),男,硕士研究生,副主任医师,从事骨科疾病的诊治,研究方向:脊柱疾病的诊断与治疗,E-mail:280310216@qq.com。 通讯作者:安小红(1981-),女,主管检验师,从事疾病基因学的研究,研究方向:脊柱疾病的基因诊断,E-mail:3499337430@qq.com。 收稿日期:2019-02-24 修回日期:2019-03-22
更新日期/Last Update: 2019-06-20