Reith H B, Mittelkötter U, Debus E S, Küssner C, Thiede A
Clinic and Policlinic of Surgery, University of Würzburg, Germany.
Dig Surg. 1998;15(3):260-5. doi: 10.1159/000018625.
A prospective clinical study was performed to assess the accuracy of procalcitonin in 70 patients with elective colorectal or aortal surgery and to compare it with inflammatory mediators. Also the early prediction of complications and the outcome of these patients was taken into account.
Laboratory variables and cytokine determination were obtained preoperatively, on the day of operation and postoperatively on a daily basis from day 1 to 5, and on days 7 and 10 in the colorectal group and in the aortal surgery group at different times on the operation day after aortal clamping. The main outcome criteria were early recognition of complications and alterations in the production of procalcitonin and cytokines in order to detect severe infective complications.
Procalcitonin was closely related to postoperative complications with significantly elevated levels at day 1 after surgery. The plasma concentrations of IL-6 increase on days 1-3 without a difference in the groups, also C-reactive protein demonstrates no differences.
Procalcitonin presents itself as a new parameter of infection and sepsis. In the postoperative period PCT seems to be an interesting marker of early prediction of infective complications when high postoperative levels are found. Under routine conditions procalcitonin is a valid reproducible and detectable parameter.
进行了一项前瞻性临床研究,以评估降钙素原在70例择期结直肠或主动脉手术患者中的准确性,并将其与炎症介质进行比较。同时还考虑了这些患者并发症的早期预测和预后情况。
术前、手术当天以及术后第1天至第5天每天,以及结直肠组和主动脉手术组在主动脉钳夹术后手术当天不同时间的第7天和第10天,获取实验室变量和细胞因子测定结果。主要结局标准是早期识别并发症以及降钙素原和细胞因子产生的变化,以便检测严重感染性并发症。
降钙素原与术后并发症密切相关,术后第1天水平显著升高。白细胞介素-6的血浆浓度在第1 - 3天升高,两组间无差异,C反应蛋白也无差异。
降钙素原是感染和脓毒症的一个新参数。在术后期间,当发现术后降钙素原水平升高时,它似乎是感染性并发症早期预测的一个有趣标志物。在常规条件下,降钙素原是一个有效的、可重复且可检测的参数。