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降钙素原作为腹部手术后医院获得性肺炎生物标志物的价值。

Value of procalcitonin as a biomarker for postoperative hospital-acquired pneumonia after abdominal surgery.

作者信息

Abu Elyazed Mohamed M, El Sayed Zaki Maysaa

机构信息

Department of Anesthesia and Surgical ICU, Faculty of Medicine, Tanta University, Tanta, Egypt.

Department of Clinical Pathology, Faculty of Medicine, Mansoura University, Mansoura, Egypt.

出版信息

Korean J Anesthesiol. 2017 Apr;70(2):177-183. doi: 10.4097/kjae.2017.70.2.177. Epub 2017 Jan 12.

Abstract

BACKGROUND

Hospital-acquired pneumonia (HAP) is a common complication after abdominal surgery. The aim of this study was to evaluate the role of procalcitonin (PCT) and C-reactive protein (CRP) as early biomarkers for the diagnosis of postoperative HAP after abdominal surgery.

METHODS

This study was conducted on 100 patients undergoing abdominal surgery. White blood cell counts, highest body temperature, and serum levels of CRP and PCT were recorded preoperatively and daily postoperatively until postoperative day (POD) 5. Chest radiography was performed preoperatively and daily postoperatively until POD 5.

RESULTS

HAP was diagnosed in 14% of patients. Regarding the biomarkers studied after POD 1, CRP and PCT were significantly higher in patients with HAP than in those without HAP (P < 0.05). On POD 2, PCT had higher sensitivity and specificity (84% and 72%, respectively) than those for CPR (70% and 60%, respectively). The cut-off value of PCT on POD 2 was 1.4 ng/ml. On POD 3, 4, and 5, the sensitivity and specificity of PCT and CRP were not significantly different.

CONCLUSIONS

PCT and CRP are accurate biomarkers for early prediction of postoperative HAP after abdominal surgery. The diagnostic ability of PCT was significantly better than that of CRP on POD 2. After POD 2, the diagnostic ability was not significantly different between the biomarkers.

摘要

背景

医院获得性肺炎(HAP)是腹部手术后常见的并发症。本研究的目的是评估降钙素原(PCT)和C反应蛋白(CRP)作为腹部手术后HAP早期诊断生物标志物的作用。

方法

本研究对100例接受腹部手术的患者进行。术前及术后每日直至术后第5天记录白细胞计数、最高体温以及CRP和PCT的血清水平。术前及术后每日直至术后第5天进行胸部X线检查。

结果

14%的患者被诊断为HAP。关于术后第1天之后所研究的生物标志物,HAP患者的CRP和PCT显著高于无HAP的患者(P < 0.05)。在术后第2天,PCT的敏感性和特异性(分别为84%和72%)高于CRP(分别为70%和60%)。术后第2天PCT的临界值为1.4 ng/ml。在术后第3天、第4天和第5天,PCT和CRP的敏感性和特异性无显著差异。

结论

PCT和CRP是腹部手术后早期预测HAP的准确生物标志物。术后第2天PCT的诊断能力显著优于CRP。术后第2天之后,这些生物标志物的诊断能力无显著差异。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7f9b/5370307/a9022ee77d07/kjae-70-177-g001.jpg

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