| 黄格,施正生,赵鹏,等.脑脊液降钙素原在开颅术后发热病人颅内感染早期诊治中的价值[J].安徽医药,2020,24(6):1109-1113. |
| 脑脊液降钙素原在开颅术后发热病人颅内感染早期诊治中的价值 |
| The value of cerebrospinal fluid procalcitonin in the early diagnosis and treatment of central nervous system infections in patients with fever after craniotomy |
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| DOI：10.3969/j.issn.1009?6469.2020.06.012 |
| 中文关键词: 中枢神经系统感染/诊断 降钙素原 脑脊液 发热 诊断 |
| 英文关键词: Central nervous system infections/diagnosis Procalcitonin Cerebrospinal fluid Fever Diagnosis |
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| 中文摘要: |
| 目的探讨脑脊液降钙素原在开颅术后发热病人发生颅内感染早期诊治中的价值。方法选取 2018年 2月至 2019年 1月在安徽医科大学附属安庆医院神经外科开颅术后符合条件的发热病例 94例，在发热第 1、3、5、7天收集脑脊液进行常规生化、降钙素原及细菌培养，同时进行血清降钙素原检测。结果发热病人中确诊颅内感染病人 40例，纳入感染组；确诊非颅内感染病人 54例，纳入非感染组。发热第 1天，感染组脑脊液降钙素原值( 0.62±0.32)μg/L明显高于非感染组( 0.26±0.27)μg/L(P＜0.05)。依据受试者工作特征曲线( ROC)分析，脑脊液降钙素原在发热第 1天诊断颅内感染的曲线下面积最高，其值为 0.861，脑脊液降钙素原的诊断准确率明显高于其他指标。感染组中 24例病人颅内感染症状得以控制，其脑脊液降钙素原呈逐渐下降趋势；而 16例病人颅内感染控制不佳，其脑脊液降钙素原继续保持较高水平。从发热后第 3天起，感染控制组脑脊液降钙素原水平明显低于感染未控制组( P＜0.05)。结论脑脊液降钙素原对开颅术后发热病人发生颅内感染的早期诊断具有一定的临床应用价值，脑脊液降钙素原水平的动态变化对颅内感染严重程度及抗感染治疗效果有一定的预测价值。 |
| 英文摘要: |
| Objective To evaluate the value of cerebrospinal fluid(CSF)procalcitonin(PCT)in the early diagnosis of central ner? vous system infections in patients with fever after craniotomy.Methods The CSF of 94 eligible patients，who underwent craniotomyin the Department of Neurosurgery of Anqing Affiliated Hospital of Anhui Medical University from February 2018 to January 2019， were collected for routine biochemical，PCT and culture assessment on days 1，3，5 and 7 after fever.At the same time，venous blood was collected for PCT levels.Results Among the patients with fever，40 cases who were diagnosed as central nervous system infec? tions were included in the infection group，and 54 cases who were diagnosed as no central nervous system infections were includedin the non?infection group.On the first day after fever，the level of CSF PCT of the infection group was significantly higher than that of the non?infection group［( 0.62±0.32)μg/L vs.(0.26±0.27)μg/L，P＜0.05］.According to the receiver operating characteristic curve(ROC)analysis，the area under the curve of CSF PCT for diagnosing central nervous system infections on the first day of fe? ver was the highest，and its value was 0.861.The diagnostic accuracy of CSF PCT was higher than other indexes.In the infection group，the central nervous system infections symptoms of 24 patients were controlled，and the CSF PCT showed a gradually decreas? ing trend.However，the central nervous system infections symptoms of the other 16 patients were poorly controlled，and the CSF PCT continued to maintain a high level.From the 3rd day after fever，the level of CSF PCT in the infection?controlled group was sig? nificantly lower than that in the infection?uncontrolled group(P＜0.05).Conclusion The CSF PCT level has certain clinical appli?cation value for the early diagnosis of central nervous system infections in patients with fever after craniotomy，the dynamic changeof which has certain predictive value for the severity of central nervous system infections and the anti?infection efficacy. |
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