[1]武元星　郝京京　王　强.血清及脑脊液降钙素原在神经外科术后颅内感染早期诊断中的应用[J].中国临床神经外科杂志,2017,(04):237-238,241.[doi:10.13798/j.issn.1009-153X.2017.04.010]
　WU Yuan-xing,HAO Jing-jing,WANG Qiang..Value of procalcitonin in serum and cerebrospinal fluid to diagnosis of intracranial infection early after craniotomy[J].,2017,(04):237-238,241.[doi:10.13798/j.issn.1009-153X.2017.04.010]
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血清及脑脊液降钙素原在神经外科术后颅内感染早期诊断 中的应用()
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《中国临床神经外科杂志》[ISSN:1009-153X/CN:42-1603/TN]

卷:
期数:
2017年04期
页码:
237-238,241
栏目:
论著
出版日期:
2017-04-25

文章信息/Info

Title:
Value of procalcitonin in serum and cerebrospinal fluid to diagnosis of intracranial infection early after craniotomy
文章编号:
1009-153X（2017）04-0237-02
作者:
武元星　郝京京　王　强
100029 北京，首都医科大学附属北京安贞医院呼吸与危重症医学科（武元星）；100050 北京，首都医科大学附属北京天坛医院ICU（郝京京、王　强）
Author(s):
WU Yuan-xing1;  HAO Jing-jing2;  WANG Qiang2.
1. Respiratory and Critical Care Medicine Department, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China, 2. Intensive Care Unit, Beijing Tiantan Hospital, The Capital Medical University, Beijing 100050, China
关键词:
颅内感染; 血清; 脑脊液; 降钙素原; 诊断
Keywords:
Postoperative intracranial infection;  Craniotomy;  Serum;  Cerebrospinal fluid;  Procalcitonin;  Diagnosis
分类号:
R 651.1+1; R 619+.3
DOI:
10.13798/j.issn.1009-153X.2017.04.010
文献标志码:
A
摘要:
目的 探讨血清及脑脊液降钙素原（PCT）在神经外科术后颅内感染早期诊断中的价值。方法 2013年9月至2015年9月北京天坛医院神经外科术后保留术腔/脑室引流的病人共90例，术后第1、3、5、7、10天经引流管留取脑脊液，同时取空腹静脉血进行PCT检测。结果 术后确诊颅内感染40例（感染组），无颅内感染50例（无感染组）。感染组脑脊液PCT水平先升高，后降低；而无感染组呈逐渐降低趋势。术后第1天，感染组与无感染组脑脊液PCT水平无统计学差异（P>0.05）；术后第3天，感染组脑脊液PCT水平明显高于无感染组（P<0.05）；随后，两组脑脊液PCT水平无统计学差异（P>0.05）。两组术后血清PCT水平均呈逐渐下降趋势。术后1、5、7 d，观察组血清PCT水平明显高于对照组（P<0.05）。以脑脊液PCT≥0.17 ng/ml为界，诊断颅内感染的敏感度为72.2%，特异度为89.6%；以血清PCT≥0.21 ng/ml为界，诊断颅内感染的敏感度为83.3%，特异度为100%。结论 术后第1天脑脊液PCT升高，可能与手术炎性刺激有关。术后第3天脑脊液PCT增高可作为预测颅内感染的指标。
Abstract:
Objective To investigate the value of serum and cerebrospinal fluid (CSF) procalcitonin (PCT) in the early diagnosis of intracranial infection after the craniotomy. Methods The levels of the serum and CSF PCT were determined 1, 3, 5, 7 and 10 days after the operation in 90 patients receiving the craniotomy from September, 2013 to September, 2015, of whom, 40 suffered from intracranial infection (infection group) and 50 not (no infection group). Results The levels of CSF PCT of the infection group were increased first and then decreased, while the no infection group decreased gradually. There was no significant difference in the level of CSF PCT between the two groups 1 day after operation (P>0.05). Three days after operation, the level of CSF PCT in the infection group was significantly higher than that in the no infection group (P<0.05). There was no significant difference in the level of CSF PCT between the two groups 5, 7 and 10 days after operation (P>0.05). The levels of serum PCT in the two groups were gradually decreased after operation. The level of serum PCT in the infection group was significantly higher than that in the no infection group 1, 5 and 7 days after operation (P<0.05). The sensitivity and specificity of the level of CSF PCT ≥0.17 ng/ml to diagnosis of intracranial infection early after the operation were 72.2% and 89.6% according to the receiver operator characteristic curve, respectively. The sensitivity and specificity of the serum PCT≥0.21 ng/ml to diagnosis of intracranial infection early after the operation were 83.3% and 100% according to the receiver operator characteristic curve, respectively. Conclusion The CSF increased in the first day after operation may be related to the inflammatory stimulation after the craniotomy. The increase in the level of CSF PCT 3 days after the operation is possible to predict the occurrence of intracranial infection.

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备注/Memo

备注/Memo:
基金项目：2013年度首都医科大学基础临床科研合作课题
通讯作者：王　强，E-mail：ttyywq@163.com
更新日期/Last Update: 2017-04-25