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目的:探讨糖尿病足(DF)不同感染程度及治疗后不同转归患者血清降钙素原(PCT)、血清超敏C-反应蛋白(hs-CRP)和血白细胞(WBC)水平的变化,分析PCT、hs-CRP与WBC对DF感染诊断的敏感度和特异度,评价其临床价值。方法:选取78例确诊为DF的住院患者为观察对象,按照感染程度分为单纯DF无感染组、轻度感染组、中度感染组和重度感染组,测定各组患者PCT、hs-CRP和WBC的水平,并对4组患者的检测结果进行比较分析。常规控制血糖,感染患者给予抗菌治疗后依不同转归分为治愈组、好转组和无效组,分析各组患者PCT、hs-CRP和WBC的水平。结果:各感染组PCT、hs-CRP和WBC水平均高于无感染组,且PCT、hs-CRP和WBC均随DF感染程度的加重而逐渐升高,差异有统计学意义(P<0.05);而各感染组治疗后无效组和好转组的PCT和hs-CRP比治愈组的水平高,治疗无效组WBC计数比好转组和治愈组增高,差异均有统计学意义(P<0.05);但PCT对DF感染诊断的敏感度和特异度均比hs-CRP高,差异有统计学意义(P<0.05)。结论:PCT和hs-CRP对于DF感染的早期诊断、感染程度的判断、监测疗效和判断预后均具有一定的临床意义,但PCT可能比hs-CRP更敏感,特异性更高。
Objective: To investigate the changes of serum levels of procalcitonin (PCT), serum hs-CRP and WBC in patients with different degrees of DF infection and different outcomes after treatment PCT, hs-CRP and WBC on the diagnosis of DF infection sensitivity and specificity, evaluation of its clinical value. Methods: Seventy-eight inpatients diagnosed with DF were selected as observation subjects. According to the degree of infection, the patients were divided into two groups: uninfected DF group, mild infection group, moderate infection group and severe infection group. The levels of PCT, hs-CRP and WBC levels, and the results of the four groups of patients for comparative analysis. Routine control of blood glucose, infection in patients given antimicrobial therapy according to different outcomes were divided into cured group, improved group and ineffective group, analysis of each group of patients PCT, hs-CRP and WBC levels. Results: The levels of PCT, hs-CRP and WBC in each infection group were higher than those in non-infected group, and PCT, hs-CRP and WBC increased with the severity of DF infection, the difference was statistically significant (P <0.05) (P <0.05). However, the PCT and hs-CRP levels of the invalid group and the remission group were higher than those of the cured group after treatment. The WBC count of the ineffective group was higher than that of the improved group and the cured group (P <0.05). However, the sensitivity and specificity of PCT for the diagnosis of DF infection were higher than that of hs-CRP, the difference was statistically significant (P <0.05). Conclusions: PCT and hs-CRP are of clinical significance for the early diagnosis of DF infection, the judgment of the degree of infection, the curative effect and the prognosis of prognosis. However, PCT may be more sensitive and specific than hs-CRP.