前降钙素在创伤性脑损伤患者病情评估和预后判断中的应用价值

摘要

Objective To explore the application value for severity assessment and prognosis of procalcitonin in pa-tients with traumatic brain injury.Methods 92 patients with traumatic brain injury from March 2010 to March 2013 in our hospital were chosen.According to the Glasgow coma score (GCS),the patients were divided into mild brain injury group (53 cases)and severe brain injury group (39 cases).At the same time,the patients were divided into infected group (39 cases)and non infected group (53 cases)according to whether infected within a week.The level of procalci-tonin of the subjects were detected on 1,3,5,7 days of hospitalization and compared between mild brain injury group and severe brain injury group,infected group and non infected group.Kaplan-Meiers survival analysis was used to ana-lyze the relationship between level of procalcitonin and 28 days survival.Results The levels of procalcitonin of subjects in severe brain injury group on 1,3,5,7 days were all significantly higher than those of patients in mild brain injury group (all P <0.05).The GCS scores of patients were negatively correlated with level of procalcitonin (r=0.532,P <0.05).The levels of procalcitonin of subjects in infected group on 3,5,7 days were all significantly higher than those of non infected group (all P <0.05).The 28-days survival rate of patients with normal levels of procalcitonin in admission was significantly higher than the patients with high levels of procalcitonin (χ2 =5.821,P =0.016).Conclusion It has guiding significance of dynamic monitoring of levels of procalcitonin in evaluation of severity of traumatic brain injury, infection diagnosis and the prognosis.%目的：探讨前降钙素在创伤性脑损伤患者病情评估和预后判断中的应用价值。方法选择2010年3月-2013年3月期间我院收治的创伤性脑损伤患者92例，根据入院时格拉斯哥昏迷指数评分分为轻度脑损伤组（53例）和重度脑损伤组（39例）。同时，根据患者入院1周内有无发生感染分为感染组（39例）和无感染组（53例）。所有患者均在入院后第1、3、5、7天检测前降钙素水平，比较轻度脑损伤组与重度脑损伤组、感染组与无感染组患者的前降钙素水平；同时采用 Kaplan-Meiers 生存分析比较入院前降钙素水平正常和升高患者的28天生存情况。结果重度脑损伤组患者入院第1、3、5、7天的前降钙素水平均显著高于轻度脑损伤患者（均 P ＜0．05）；患者入院时格拉斯哥昏迷评分与前降钙素水平呈负相关（r＝0．532，P ＜0．05）；感染组患者入院第3、5、7天的前降钙素水平均显著高于无感染组患者（均 P ＜0．05）；入院时前降钙素水平正常的患者28天生存率显著高于入院时前降钙素水平升高的患者（χ2＝5．821，P ＝0．016）。结论动态监测前降钙素水平变化情况，对创伤性脑损伤患者病情的评估、感染的诊断和预后的判断均具有重要的临床意义。