To Investigate Diagnositic Significance Of Serum Procalcitonin On Postoperation Infection In Patients With Extremities Fracture

Objective:To monitor plasma procalcitonin(PCT) levels in the postoperative infection patients with extremities fracture and evaluate its diagnostic value for bacterial infections.Methods:We select a sample of40hospitalized infective patients with extremities fracture operation from January2008to December2010in our hospital.The patients were grouped into infected(I group,n=20) and disinfected(D group,n=20).PCT,CRP and WBC values were detected1st,4th,9th and14th days after operation in disinfected group,1st day afteroperation,before germiculture and using antibacterials,24h before2nd operation and5th day after2nd operation in infected group.The results were compared with those taken from the healthy controls.Area under the receiver operating characteristic curve(AucRoc) were used to evaluate the index value in diagnosing postoperative infections.Results:1.PCT,CRP and WBC values in1st day after operation between infected group(I group) and disinfected group(D group) show no significant difference(P>0.05),but all are significantly higher than those of healthy controls.2. PCT,CRP and WBC values in the days before germiculture and using antibacterials,24h before2nd operation in infected group(I group) show significant difference to disinfected group(D group)(P<0.01).3. PCT,WBC values in the day before germiculture and using antibacterials in infected group(I group) are significantly higher than that of1st day afteroperation (P<0.05),no as CRP.4.PCT,CRP values in the day before germiculture and using antibacterials in infected group(I group) are significantly higher than that of24h before2nd operation (P<0.01),no as WBC.5. PCT,WBC values in the day before germiculture and using antibacterials in infected group(I group) are much more higher than that of5th day after2nd operation (P<0.01),no as CRP.6.PCT has good sensitivity(95%),specificity(90%),positive predictive value(90%) and negative predictive value(95%),and they are almost much higher than those of CRP(90%),(60%),(69%),(86%) and WBC(95%),(85%),(86%),(94%).Conclusion:1.Detection of serum PCT could serve as an early indicator of bacterial infection,serum PCT for the diagnosis on postoperative infection in the patients with extremities fracture has high sensitivity and specificity.2.Monitoring value of serum PCT dynamically can reflect the severity and progress of bactrrial infection,and provide objective evidence for clinicians to assess the disease and adjust treatment.Its effectiveness is superior to CRP and WBC.