Page 15 - 麻醉与监护论坛2015年第5期

Cover Thesis
100%, specificity was 75.5%, accuracy was 84.4%, positive
predictive value 70%, negative predictive value was 100%,
positive likelihood ratio was 1.32, and negative likelihood
ratio was 0. This study showed the self-created method
of quantitative detection of serum PCT can be used for
clinical detection and has good detection performance,
has the early diagnostic value in elderly trauma patients’
co-infection.
Discussion
In recent years, traffic accidents, natural disasters,
engineering construction, such as trauma incidence
increased year by year, trauma has become one of the
main causes of human death. The immune function of
elderly patients also low, often with complicated condition,
uncontrolled hemorrhagic shock, hypoxemia and acidosis,
inflammatory cytokines induced a large of release easily
elderly patients with systemic inflammatory response,
eventually leading to sepsis and multiple organ function
failure and death [3]. Therefore, to correctly assess disease
in elderly patients with trauma, monitoring condition
changes, predicting concurrent infection is very important.
PCT is a kind of inflammatory medium [4], and level of
normal is often less than 0.1ng/ml, as bacterial, fungal and
parasitic infections and sepsis, the PCT levels significantly
raise, closely related to the severity and prognosis of
traumatic inflammation [5].
This study used the size uniformly dispersed
polystyrene microspheres as antibody carrier, established
a new method for quantitative detection serum PCT, and
provides new ideas and methods to diagnosis. Results
showed that the sensitivity of self-created method was
45.42pg/ml, the linear range was 45.42pg/ml-10ng/
ml; the CV was 5.37% in the geriatric trauma group,
the CV was 8.74% in the control group according to
the provisions of good detection performance, and
particularly for the elderly is set under the positive limit
(0.56ng/ml).
Geriatric trauma patients clinical data, through
the analysis of the prospective high mortality rate, the
mortality of low ISS group was obviously higher than that
of high ISS group, APACHE Ⅱ score maintained at a high
level at 5d, the APACHE Ⅱ score of low ISS group declined
at 3d, the level of PCT at a high level at 5d, the correlation
Laboratory and Clinical CInovveesrtiTghaetisoins 96 FAM 2013 Mar/Apr Vol.20 Issue 2
of PCT and APACHE Ⅱ was decreased, CRP has no less
correlation with APACHE Ⅱ, consistent with relevant
domestic reports [6], the author thinks that: CRP in geriatric
trauma patients condition monitoring is lagging and the
specificity is not high, PCT in evaluating elderly traumatic
condition and predicting infection is superior to CRP. Using
the self- created method to create PCT, in the positive point
of 0.56ng/ml evaluation of complicated infections in elderly
patients with trauma, the sensitivity was 100%, specificity
was 75.5%, the accuracy was 84.4%, positive predictive
value was 70%, negative predictive value was 100%, positive
likelihood ratio was 1.32, negative likelihood ratio was 0.
This experiment established the quantitative detection
of serum PCT method can be used as a new method for
clinical, early diagnosis of complicated infections in elderly
patients with trauma of high sensitivity, specific, and the
applicable to clinical diagnosis and monitoring of the
infection.
This study successfully established the method
to detect the serum PCT quantitative model, and
especially for the elderly to set a positive point, have
a higher clinical diagnostic value of clinical early
accurate evaluation of elderly trauma infection patients,
monitoring and predicting prognosis and has clinical
guidance value.
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