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降钙素原是否可作为脊髓损伤患者脓毒症的可靠指标:一项观察性队列研究。

Is procalcitonin a reliable indicator of sepsis in spinal cord injury patients: an observational cohort study.

机构信息

King's College London, London, UK.

Yorkshire Regional Spinal Injuries Centre, Mid Yorkshire NHS Trust, Wakefield, UK.

出版信息

Eur Spine J. 2023 May;32(5):1591-1597. doi: 10.1007/s00586-023-07609-4. Epub 2023 Mar 26.

Abstract

STUDY DESIGN

Prospective observational cohort study.

OBJECTIVE

To understand if serum procalcitonin (PCT) is a reliable indicator of sepsis in spinal cord injury (SCI) patients for better prognosis and earlier diagnosis when compared with other common biomarkers such as C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), white blood cells (WBC), blood culture and body temperature.

METHODS

From March 2021 to August 2022, data were collected for SCI patients who developed septicaemia. In addition to neurology and admission, the following blood samples were collected on day one of infection: PCT, CRP and WBC. Linear regression analysis was performed to determine the relationship between PCT, CRP and WBC.

RESULTS

A total of 27 SCI patients had an infection during their stay in the regional centre; however, only 10 developed septicaemias. 100% of SCI individuals with sepsis had elevated PCT levels, whilst 60% had elevated CRP and 30% had elevated WBC levels. There was a strong positive correlation between PCT and CRP (R = 0.673, CI = 95%, 5.5-22.8, p < 0.05) and a weaker positive correlation between PCT and WBC (R = 0.110, CI = 95%, 4.2-10.9, p < 0.05).

CONCLUSION

In SCI individuals, there was a correlation between serum PCT levels and septicaemia. Alongside this, PCT appeared to be more consistent throughout the study population when compared with CRP and WBC. However, this was a preliminary study and further research is required on a larger scale.

摘要

研究设计

前瞻性观察队列研究。

目的

与其他常见生物标志物(如 C 反应蛋白(CRP)、红细胞沉降率(ESR)、白细胞(WBC)、血培养和体温)相比,了解血清降钙素原(PCT)是否可作为脊髓损伤(SCI)患者脓毒症的可靠指标,以便更好地进行预后和早期诊断。

方法

2021 年 3 月至 2022 年 8 月,收集发生败血症的 SCI 患者的数据。除神经学和入院外,在感染的第一天还采集以下血液样本:PCT、CRP 和 WBC。进行线性回归分析以确定 PCT、CRP 和 WBC 之间的关系。

结果

共有 27 名 SCI 患者在区域中心住院期间发生感染,但只有 10 名患者发生败血症。100%发生败血症的 SCI 个体 PCT 水平升高,而 60%的 CRP 升高,30%的 WBC 升高。PCT 与 CRP 之间存在很强的正相关(R = 0.673,CI = 95%,5.5-22.8,p < 0.05),而 PCT 与 WBC 之间存在较弱的正相关(R = 0.110,CI = 95%,4.2-10.9,p < 0.05)。

结论

在 SCI 个体中,血清 PCT 水平与败血症之间存在相关性。此外,与 CRP 和 WBC 相比,PCT 在整个研究人群中似乎更一致。然而,这是一项初步研究,需要在更大规模上进行进一步研究。

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