Balci C, Sivaci R, Akbulut G, Karabekir H S
Department of Anaesthesiology, Afyon Kocatepe University School of Medicine, Afyonkarahisar, Turkey.
J Int Med Res. 2009 Nov-Dec;37(6):1709-17. doi: 10.1177/147323000903700606.
This prospective study investigated the levels of procalcitonin (PCT) and C-reactive protein (CRP) in patients with various types and severity of multiple trauma, and their relationship to trauma-related complications. Adult multiple-trauma patients (n = 113) admitted to the intensive care unit (ICU) in the first 24 h after trauma were included. The Injury Severity Scores (ISS), and PCT and CRP levels were measured in the first 24 h (day 1), on day 7 and on the final day of their ICU stay. Survival at 30 days was recorded. Mean PCT and CRP levels were both significantly higher on day 7 compared with day 1 and the final assessment day in patients with an ISS > 20. Levels of PCT were significantly higher in cases with sepsis, severe sepsis or septic shock compared with cases who developed systemic inflammatory response syndrome (SIRS), however levels of CRP were significantly higher only in cases with severe sepsis or septic shock, but not in cases with sepsis alone. These data support the view that PCT levels may be a better indicator than CRP levels in the early diagnosis of septic complications in patients with multiple trauma.
这项前瞻性研究调查了不同类型和严重程度的多发伤患者的降钙素原（PCT）和C反应蛋白（CRP）水平，以及它们与创伤相关并发症的关系。纳入了创伤后24小时内入住重症监护病房（ICU）的成年多发伤患者（n = 113）。在入住ICU的第1天（创伤后24小时内）、第7天和最后一天测量损伤严重程度评分（ISS）、PCT和CRP水平。记录30天的生存率。ISS>20的患者中，第7天的平均PCT和CRP水平均显著高于第1天和最终评估日。与发生全身炎症反应综合征（SIRS）的患者相比，脓毒症、严重脓毒症或脓毒性休克患者的PCT水平显著更高，然而，仅严重脓毒症或脓毒性休克患者的CRP水平显著更高，单纯脓毒症患者则不然。这些数据支持这样一种观点，即在多发伤患者脓毒症并发症的早期诊断中，PCT水平可能是比CRP水平更好的指标。
