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J Surg Res：降钙素原联合白细胞预测心脏手术患者感染风险

2017-07-30 MedSci MedSci原创

降钙素原感染术后
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术后并发脓毒症可极大程度增加术后患者死亡率、住院时间、医疗费用。心脏手术后的早期临床症状与全身炎症反应综合征通常会发生重叠，这种反应在心脏手术体外循环后通常都会发生。联合数种生物标志物预测术后感染已经被之前的试验证实，本研究的目的是检测C反应蛋白（CRP）、白细胞（WBC）和降钙素原（PCT）是否能够预测心脏手术后的感染。

术后并发脓毒症可极大程度增加术后患者死亡率、住院时间、医疗费用。心脏手术后的早期临床症状与全身炎症反应综合征通常会发生重叠，这种反应在心脏手术体外循环后通常都会发生。联合数种生物标志物预测术后感染已经被之前的试验证实，本研究的目的是检测C反应蛋白（CRP）、白细胞（WBC）和降钙素原（PCT）是否能够预测心脏手术后的感染。

423例进行体外循环心脏手术患者的病例被纳入对照研究。根据术后是否发生严重脓毒症或脓毒症休克，回顾性将患者分为两组。在入ICU的第一天，抽取血样进行生物标记物测量（PCT、CRP和WBC），之后每天早上复测一次，持续到术后第十天。

两组CRP中位数相似。手术后第一个10天内已获感染者的WBC和PCT值显著高于未感染患者，升高值小于等于3倍（OR：4.058；95% CI：2.206-7.463；P=0.001）和大于等于4倍（OR：10.274，95% CI：3.690-28.604；P＜0.001），PCT中位数值（1.7ng/mL）和/或白细胞（13000/mm3）与手术后感染有明显关系。

本研究对大量的心脏手术患者进行分析，以确保样本量的可信性。结果显示，术后三天的PCT联合WBC水平能够预测心脏术后30 天内的术后感染。

原始出处：

Heredia-Rodríguez M1， Bustamante-Munguira J2，et al. Procalcitonin and white blood cells， combined predictors of infection in cardiac surgery patients. J Surg Res. 2017 May 15；212：187-194. doi： 10.1016/j.jss.2017.01.021. Epub 2017 Feb 1.

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    2017-08-01 wrj0121

    #降钙素原#

    0

  2. 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    2017-07-31 1e1b8538m79(暂无匿称)

    不错的文章，值得推荐

    0

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    2017-07-31 清风拂面

    谢谢分享，学习了

    0

  4. 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createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLGSUSR8zwnWWLT4FMl5XH8S58HuZslVkLsAPbXDXaliagK7TOxQfmngKibG1yrDonepCLDkcxGk8hS/0, createdBy=b8282062892, createdName=changjiu, createdTime=Sun Jul 30 21:11:00 CST 2017, time=2017-07-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=228159, encodeId=4d8e22815918, content=非常好的文章，学习了，很受益, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7LIiaRZTzJ3SEfiauCzTMPW7YvPPYLNJBXG9oh6Al1icq2VQQkIHWxqXehcicTS62YKJVBhxeth3wggw/0, createdBy=7ce01621306, createdName=天涯183, createdTime=Sun Jul 30 20:36:34 CST 2017, time=2017-07-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=228145, encodeId=443d22814577, content=学习一下, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6KcicAVC1MwuOgo3iaicb1Imgk1yIfnvr6oXzibcAFB6puAyNJXbzWhNuLqaFYBVRWjh7rghkvFLPxMAfD5ib3nXwVD/0, createdBy=bed21972958, createdName=wxl882001, createdTime=Sun Jul 30 17:04:11 CST 2017, time=2017-07-30, status=1, ipAttribution=)]
    2017-07-31 laoli

    谢谢分享，学习了

    0

  5. 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topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6KcicAVC1MwuOgo3iaicb1Imgk1yIfnvr6oXzibcAFB6puAyNJXbzWhNuLqaFYBVRWjh7rghkvFLPxMAfD5ib3nXwVD/0, createdBy=bed21972958, createdName=wxl882001, createdTime=Sun Jul 30 17:04:11 CST 2017, time=2017-07-30, status=1, ipAttribution=)]
    2017-07-31 189****7206

    学习了受益匪浅

    0

  6. 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topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6KcicAVC1MwuOgo3iaicb1Imgk1yIfnvr6oXzibcAFB6puAyNJXbzWhNuLqaFYBVRWjh7rghkvFLPxMAfD5ib3nXwVD/0, createdBy=bed21972958, createdName=wxl882001, createdTime=Sun Jul 30 17:04:11 CST 2017, time=2017-07-30, status=1, ipAttribution=)]
    2017-07-30 131****2916

    不错的文章值得学习

    0

  7. 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createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLGSUSR8zwnWWLT4FMl5XH8S58HuZslVkLsAPbXDXaliagK7TOxQfmngKibG1yrDonepCLDkcxGk8hS/0, createdBy=b8282062892, createdName=changjiu, createdTime=Sun Jul 30 21:11:00 CST 2017, time=2017-07-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=228159, encodeId=4d8e22815918, content=非常好的文章，学习了，很受益, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7LIiaRZTzJ3SEfiauCzTMPW7YvPPYLNJBXG9oh6Al1icq2VQQkIHWxqXehcicTS62YKJVBhxeth3wggw/0, createdBy=7ce01621306, createdName=天涯183, createdTime=Sun Jul 30 20:36:34 CST 2017, time=2017-07-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=228145, encodeId=443d22814577, content=学习一下, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6KcicAVC1MwuOgo3iaicb1Imgk1yIfnvr6oXzibcAFB6puAyNJXbzWhNuLqaFYBVRWjh7rghkvFLPxMAfD5ib3nXwVD/0, createdBy=bed21972958, createdName=wxl882001, createdTime=Sun Jul 30 17:04:11 CST 2017, time=2017-07-30, status=1, ipAttribution=)]
    2017-07-30 清风拂面

    谢谢分享，学习了谢谢

    0

  8. 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createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLGSUSR8zwnWWLT4FMl5XH8S58HuZslVkLsAPbXDXaliagK7TOxQfmngKibG1yrDonepCLDkcxGk8hS/0, createdBy=b8282062892, createdName=changjiu, createdTime=Sun Jul 30 21:11:00 CST 2017, time=2017-07-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=228159, encodeId=4d8e22815918, content=非常好的文章，学习了，很受益, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7LIiaRZTzJ3SEfiauCzTMPW7YvPPYLNJBXG9oh6Al1icq2VQQkIHWxqXehcicTS62YKJVBhxeth3wggw/0, createdBy=7ce01621306, createdName=天涯183, createdTime=Sun Jul 30 20:36:34 CST 2017, time=2017-07-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=228145, encodeId=443d22814577, content=学习一下, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6KcicAVC1MwuOgo3iaicb1Imgk1yIfnvr6oXzibcAFB6puAyNJXbzWhNuLqaFYBVRWjh7rghkvFLPxMAfD5ib3nXwVD/0, createdBy=bed21972958, createdName=wxl882001, createdTime=Sun Jul 30 17:04:11 CST 2017, time=2017-07-30, status=1, ipAttribution=)]
    2017-07-30 changjiu

    学习了，谢谢

    0

  9. 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topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6KcicAVC1MwuOgo3iaicb1Imgk1yIfnvr6oXzibcAFB6puAyNJXbzWhNuLqaFYBVRWjh7rghkvFLPxMAfD5ib3nXwVD/0, createdBy=bed21972958, createdName=wxl882001, createdTime=Sun Jul 30 17:04:11 CST 2017, time=2017-07-30, status=1, ipAttribution=)]
    2017-07-30 天涯183

    非常好的文章，学习了，很受益

    0

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    2017-07-30 wxl882001

    学习一下

    0

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