降钙素原预测血培养阳性的临床价值研究

发布时间：2018-06-01 01:17

本文选题：降钙素原 + 血培养阳性　；参考：《中华医院感染学杂志》2016年16期

【摘要】：目的探讨血清降钙素原(PCT)预测血培养阳性的临床应用价值。方法采用回顾性分析研究,以2012年12月-2014年12月同时进行PCT和血培养检测1 164例患者为研究对象,根据血培养结果分为阳性组和阴性组,比较两组间PCT、C-反应蛋白(CRP)水平等实验室指标的差异。结果血培养阳性组PCT、CRP明显高于血培养阴性组,差异有统计学意义(P0.001);单因素logistics回归分析显示,PCT、CRP及体温均为菌血症预测因子,差异有统计学意义(P0.001),多因素logistics回归分析显示,校正年龄、抗菌药物预处理因素后,年龄、PCT、CRP是预测血培养阳性的独立预测因子;血清PCT预测血培养阳性ROC曲线下面积为0.800,当截断点为PCT0.05ng/ml时,PCT预测血培养阳性的敏感性高达96%,与其他临床实验室指标相比,PCT预测血培养阳性诊断价值最高;在PCT0.05ng/ml时,菌血症发生风险低,而PCT0.5ng/ml时,菌血症发生风险高,有利于早期诊断和病情检查,合理使用抗菌药物。结论 PCT预测血培养阳性是非常有意义的,比CRP、WBC计数和其他临床实验室指标均要好,而且血清PCT检测能够减少患者的血培养数量及医疗成本,实施更合理的卫生保健资源分配。
[Abstract]:Objective to investigate the clinical application value of serum calcitonin (PCT) in predicting the positive blood culture. Methods a retrospective analysis was carried out in 1164 patients with PCT and blood culture in December December 2012 -2014. The results were divided into positive and negative groups according to the result of blood culture, and compared the level of PCT, C- reactive protein (CRP) among the two groups. Results the difference of laboratory indexes. Results the positive blood culture group PCT, CRP was significantly higher than the negative blood culture group, the difference was statistically significant (P0.001). The single factor logistics regression analysis showed that PCT, CRP and body temperature were all predictive factors of bacteremia, the difference was statistically significant (P0.001). The multiple factor logistics regression analysis showed that the correction age, the antibacterials were pretreated. After the treatment, age, PCT, and CRP were independent predictors of positive blood culture, and serum PCT predicted that the area under the positive ROC curve of blood culture was 0.800. When the truncated point was PCT0.05ng/ml, the sensitivity of PCT to predict the positive blood culture was up to 96%. Compared with other clinical laboratory indicators, PCT predicted the positive diagnostic value of blood culture; in PCT0.0, the value of the positive blood culture was the highest; in PCT0.0 At the time of 5ng/ml, the risk of bacteremia is low and the risk of bacteremia is high at PCT0.5ng/ml. It is beneficial to early diagnosis and condition examination and rational use of antibiotics. Conclusion PCT is very meaningful to predict positive blood culture. It is better than CRP, WBC count and other clinical laboratory indexes, and serum PCT detection can reduce the blood culture of patients. To provide more reasonable allocation of health care resources by maintaining quantity and medical costs.
【作者单位】：浙江省台州医院检验科;
【基金】：浙江省科技厅基金资助项目(2016C33SA800035)
【分类号】：R446.1

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