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目的:探讨动态监测降钙素原(PCT)对重型颅脑损伤患者预后评估的意义。方法:选取2012年10月至2015年5月本院收治的72例重型颅脑损伤患者为研究对象,按入院时PCT水平高低分为观察组与对照组,动态监测并比较两组患者入住ICU第1、2、3、5、7天的血清PCT水平。分析两组PCT水平与急性生理与慢性健康评分(APACHE-Ⅱ)、格拉斯哥昏迷评分(GCS)的相关性,并比较重症监护室(ICU)内感染率、28 d死亡率。结果:入院第1、2、3、5天观察组PCT水平较对照组显著升高(P<0.05);PCT水平与APACHE-Ⅱ评分(P<0.05)呈正相关,与GCS评分(P<0.05)呈负相关;观察组ICU内感染率97.2%、28 d死亡率41.6%明显高于对照组的77.8%、30.6%(P<0.05)。结论:PCT水平较高的患者易出现各种感染且预后不良,动态监测PCT水平可能是评估重型颅脑损伤患者病情严重程度、感染及预后的有效指标。
Objective: To investigate the significance of dynamic monitoring of procalcitonin (PCT) in the prognosis evaluation of patients with severe craniocerebral injury. Methods: Seventy-two patients with severe craniocerebral injury admitted to our hospital from October 2012 to May 2015 were enrolled in this study. The PCT level at admission was divided into observation group and control group. The two groups were monitored and compared ICU Serum PCT levels on days 1, 2, 3, 5 and 7. The correlation between PCT levels and acute physiology and chronic health score (APACHE-Ⅱ) and Glasgow Coma Scale (GCS) was analyzed. The infection rate in intensive care unit (ICU) and the mortality rate at 28 days were compared. Results: The PCT level in the observation group was significantly higher than that in the control group on the 1st, 2nd, 3rd and 5th day after admission (P <0.05). The PCT level was positively correlated with the APACHE-Ⅱ score (P <0.05) ). The infection rate in ICU of observation group was 97.2% and the mortality rate of 41.6% at 28 days was significantly higher than that of control group (77.8%, 30.6%, P <0.05). CONCLUSIONS: Patients with high PCT levels are prone to various infections and have poor prognosis. Dynamic monitoring of PCT levels may be an effective indicator for assessing the severity, infection and prognosis of patients with severe craniocerebral injury.