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目的:目的探讨白细胞介素1β(IL-1β)联合降钙素原(PCT)检测对重症颅脑损伤的临床诊断及预后评估价值。方法:重症颅脑损伤患者82例,根据入院后感染的发生情况分为未感染组44例和感染组38例;选择同期进行健康体检者40例为对照组。检测感染第1、3、5天患者的IL-1β、PCT、C反应蛋白(CRP)及白细胞(WBC)计数值并对比。记录抗生素治疗后患者的预后情况,分析其与IL-1β、PCT值的相关性。结果:感染组及未感染组CRP、WBC显著高于对照组(P<0.05);感染组IL-1β及PCT值均显著高于未感染组和对照组(P<0.05);未感染组患者的IL-1β值显著高于对照组(P<0.05),2组PCT值差异无统计学意义(P>0.05)。感染组患者在第1、3、5天的PCT值及IL-1β值均显著高于未感染组(P<0.05);感染组患者入院后IL-1β与PCT值均逐渐升高,第3天达到峰值,相关性分析显示IL-1β与PCT水平呈正相关(r=0.81,P<0.05)。感染组患者经抗生素联合治疗,病情好转33例,病情恶化5例;病情好转患者治疗前PCT与IL-1β值均显著低于病情恶化患者(P<0.05)。结论:IL-1β与PCT联合检测对重型颅脑损伤感染患者早期诊断可能有良好的应用价值。
Objective: To investigate the clinical diagnosis and prognosis evaluation of interleukin-1β (IL-1β) combined with procalcitonin (PCT) in severe craniocerebral injury. Methods: Eighty-two patients with severe traumatic brain injury were divided into uninfected group (n = 44) and infected group (n = 38) according to the incidence of post-hospital infection. Forty healthy subjects were selected as control group in the same period. The levels of IL-1β, PCT, C-reactive protein (CRP) and white blood cell (WBC) were detected and compared on the 1st, 3rd and 5th day after infection. The prognosis of patients after antibiotic treatment was recorded and their correlations with IL-1β and PCT values were analyzed. Results: The CRP and WBC in infected and uninfected groups were significantly higher than those in control group (P <0.05). The levels of IL-1β and PCT in infected group were significantly higher than those in uninfected group and control group (P <0.05) IL-1β was significantly higher than that of the control group (P <0.05). There was no significant difference in PCT value between the two groups (P> 0.05). The PCT and IL-1β values in the infection group were significantly higher than those in the uninfected group on the 1st, 3rd and 5th days (P <0.05); IL-1β and PCT values in the infection group were gradually increased after admission Day. The correlation analysis showed that there was a positive correlation between IL-1β and PCT level (r = 0.81, P <0.05). The infected patients were treated with antibiotics, the condition improved in 33 cases and the condition deteriorated in 5 cases. The levels of PCT and IL-1β in patients with improved condition were significantly lower than those in patients with worsening condition (P <0.05). Conclusion: The combined detection of IL-1β and PCT may have a good value in the early diagnosis of severe craniocerebral injury.