Page 14 - 麻醉与监护论坛2015年第5期

Cover Thesis
so the create method to detect in elderly patients with trauma ISS group at 1d (P<0.05). The CRP levels of elderly
under the PCT positive limit of 0.56ng/ml.
2.6 Preliminary clinical application
2.6.1 Characteristics of trauma-induced old major
trauma patients and control patients (Tab 1)
High ISS group has no statistical significance with Low
ISS group, between elderly patients gender and age, are in
the majority with men. The mortality (28.13%) of High
ISS group was obviously higher than that of low ISS group
(6.67%). (P<0.01) The ISS score and GCS score of high
ISS group has significant difference with low ISS group
(P<0.01). Low ISS group 45 cases, 34 cases (75.6%) for a
single blunt injury, 7 cases (21.8%) for a single blunt injury remainder period, the r values are less than 0.50. At 1d,
of high ISS group 32 cases, the rest of the patients were
penetrating injury. The APACHE Ⅱ score of low ISS group
was (9.8 + 0.6), significantly lower than high ISS group
(P<0.01).
2.6.2 Comparison of APACHE Ⅱ, PCT, CRP
between High-ISS, Low-ISS and Control group (Tab 2)
The APACHE Ⅱ score of High ISS group maintained
at a high level at 5d, the APACHE Ⅱ score of low ISS
group rapidly decrease after the peak at 3d, the data of
two groups has significant difference (P<0.05). Two
groups of elderly trauma patients during 10d observation
period, compared with control group, serum PCT levels
were significantly higher (P<0.01). Compared with low
ISS group, serum PCT of high ISS group at a high level
at 5d (P<0.01) and maintained at a higher level (P<0.05);
low ISS group rapidly decrease after the peak at 5d, but
the PCT of high ISS group has been maintained at a
high level. High ISS has significant difference with low
Fig 4 The change of PCT, CRP and APACHE Ⅱ
Laboratory and Clinical CInovveesrtiTghaetisoins 95 FAM 2013 Mar/Apr Vol.20 Issue 2
trauma group and CRP levels were significantly higher
than control group (P < 0.01), the CRP level of high ISS
group at a high level at 5d, in the observation period,
the two groups have statistical significance at 1d and 10d
(P<0.05), two groups have significant difference at 3, 5, 7
d (P<0.01).
2.6.3 The correlation analysis of PCT, CRP and
APACHE Ⅱ score (Fig.4)
At 1d, CRP has no correlation with APACHE Ⅱ score,
r=0.375 (P>0.05); the highest r value was 0.563 at 5d, the
PCT has correlation with APACHE Ⅱ score, r=0.421; the
correlation is on the rise, the highest r value was 0.783
at 10d, the rest time, that is always at a high level. These
pointed that PCT has better correlation with APACHE Ⅱ
than CRP.
2.6.4 The diagnostic value in elderly trauma
patients of PCT (Tab.3)
77 cases of elderly trauma patients, according to
whether amalgamative infection situation, divided into
infection group (28 cases) and the uninfected group
(49 cases). Co-infection of diagnostic criteria: 1) there
is a clear focal infection of pathogenic microbiology
and inspection is positive; 2) no clear focal infection of
pathogenic microbiology and check the negative, but
with typical signs and symptoms of infection in patients
with sensitive effective antimicrobial therapy for patients
with specification, immunological tests without a severely
weakened immune system. Using the self-created method
to test the elderly trauma patients serum PCT, according
to the set of elderly patients with trauma under the PCT
positive limit of 0.56ng/ml, the result shows that there has
28 cases PCT> 0.56ng/ml; Uninfected group has 12 cases
PCT >0.56ng/ml.
The self-created method to detect the PCT level in
elderly patients with trauma co-infection, sensitivity was
Tab. 3 the diagnostic value in elderly trauma patients of PCT
PCT (ng/ml) Co-infection - Total
+ 12
≥0.56 28 37 40
<0.56 0 49 37
Total 28 77