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目的探讨血清降钙素原(PCT)与超敏C反应蛋白(hs-CRP)联合检测对老年胃十二肠溃疡急性穿孔合并腹膜炎的诊疗价值。方法选择老年胃十二肠溃疡急性穿孔患者共88例,所有患者于确诊胃十二肠溃疡急性穿孔使用抗菌药物前同时检测外周血PCT和hs-c RP水平,并同时进行白细胞计数和血培养。结果非脓毒症组、轻度脓毒症组和重度脓毒症组患者的血清PCT及hs-CRP水平依次升高,3组间差异有统计学意义(P<0.01)。非脓毒症组、轻度脓毒症组和重度脓毒症组白细胞计数依次升高,3组间差异有统计学意义(P<0.01)。非脓毒症组血培养结果阳性率为0;轻度脓毒症组血培养结果阳性者5例,占全部血培养患者的5.68%;重度脓毒症组血培养结果阳性者38例,占全部血培养患者的43.18%,3组间的差异有统计学意义(P<0.01)。结论 PCTM与hs-CRP联合检测有助于老年胃十二肠溃疡急性穿孔合并腹膜炎患者感染状况的判断以及指导抗菌药物的使用。
Objective To investigate the diagnostic value of combined detection of serum procalcitonin (PCT) and high sensitivity C-reactive protein (hs-CRP) in acute perforation of gastroduodenal ulcer patients with peritonitis. Methods A total of 88 elderly patients with gastric gastroduodenal ulcer were selected. All patients were tested for peripheral blood PCT and hs-c RP levels simultaneously with acute perforation of gastroduodenal ulcer before using antimicrobial agents, and white blood cell count and blood culture . Results The levels of serum PCT and hs-CRP in non-sepsis group, mild sepsis group and severe sepsis group increased successively, with significant difference between the three groups (P <0.01). In non-sepsis group, mild sepsis group and severe sepsis group, the white blood cell count increased in turn, the difference between the three groups was statistically significant (P <0.01). The positive rate of blood culture in non-sepsis group was 0; in the mild sepsis group, 5 cases were positive in blood culture, accounting for 5.68% of all the blood culture patients; 38 cases were positive in severe sepsis group, accounting for 43.18% of all blood culture patients, the difference between the three groups was statistically significant (P <0.01). Conclusion Combined detection of PCTM and hs-CRP is helpful to judge the infection status of acute gastroduodenal ulcer patients with perforation and peritonitis and to guide the use of antimicrobial agents.