Beloborodova N V, Popov D A
Anesteziol Reanimatol. 2005 May-Jun(3):45-9.
The diagnostic value of traditional markers of infection and procalcitonin test (PCT) in the early postoperative period was compared in 60 cardiosurgical patients with acquired cardiac diseases and at risk for postoperative infectious complications. The mean age of the patients was 51 +/- 11 years. Preoperatively, all the patients had no signs of infections. The patients were examined before and on days 1, 2, 3, and 6 after surgery. Along with the routine studies (thermometry, general blood analysis), the plasma concentration of PCT was determined by immunoluminometric technique (LUMI-test PCT, Brahms Aktiengesellschaft, Germany). The preoperative level of PCT did not exceed the normal values ( < 0.5 ng/ml). On postoperative days 2 to 17, 14 (23.3%) patients developed infectious complications (Group 2); the other patients were included into a group of comparison (Group 1). Just within the first postoperative days, the levels of PCT were significantly higher in Group 2 patients than in Group 1 (7.58 +/- 2.34 and 3.51 +/- 0.71 ng/ml, respectively; p < 0.05). A difference was found in the count of white blood cells between the groups only from day 3. There were no significant differences in body temperature between the groups. At the second stage of analysis of the data, in accordance with the level of PCT on the first day after surgery and its subsequent changes, all the patients were divided into 4 groups (A-D). The level of PCT on postoperative day was less than 0.5 ng/ml in Group A (n = 6), 0.5-2 ng/ml in Group B (n = 23) and more than 2 ng/ml in groups C (n = 26) and D (n = 5). Subsequently, it was in the normal range in Group A, decreased to the normal values in Groups B and C by day 6 following surgery. The persistence of the high level of PCT was observed in Group D where there were the bulk (60%) of infectious complications. As compared with the traditional clinical and laboratory criteria (fever, leukocytosis), PCT is the earliest and most specific marker of bacterial infection in cardiosurgical patients in the early postoperative period. The level of PCT > 3.5 ng/ml within the first 24 hours after surgery is shown to be a predictor of postoperative infectious complications.
在60例患有后天性心脏病且有术后感染并发症风险的心脏外科患者中，比较了感染传统标志物和降钙素原检测（PCT）在术后早期的诊断价值。患者的平均年龄为51±11岁。术前，所有患者均无感染迹象。在手术前以及术后第1、2、3和6天对患者进行检查。除常规检查（体温测量、血常规分析）外，采用免疫发光技术（LUMI - test PCT，德国勃林格殷格翰公司）测定血浆PCT浓度。术前PCT水平未超过正常值（<0.5 ng/ml）。在术后第2至17天，14例（23.3%）患者发生感染并发症（第2组）；其他患者纳入对照组（第1组）。仅在术后最初几天，第2组患者的PCT水平显著高于第1组（分别为7.58±2.34和3.51±0.71 ng/ml；p<0.05）。两组之间仅从第3天起白细胞计数存在差异。两组之间体温无显著差异。在数据分析的第二阶段，根据术后第一天PCT水平及其随后的变化，将所有患者分为4组（A - D）。术后第1天A组（n = 6）的PCT水平低于0.
