降钙素原在菌血症中的预测价值研究

发布时间：2018-04-12 06:53

本文选题：血培养 + 菌血症　；参考：《国际检验医学杂志》2014年12期

【摘要】：目的探讨降钙素原(PCT)预测菌血症的价值。方法回顾性收集临床各科室首次初诊菌血症成人患者,记录初次血培养采集时,白细胞计数(WBC)、中性粒细胞绝对值(NEU)、PCT结果,运用受试者工作特性曲线(ROC)评价各炎症指标对菌血症的预测价值。结果在研究期间,共纳入120例临床初诊菌血症成人患者,其中菌血症组有47例(39.2%),非菌血症组73例(60.8%)。菌血症组WBC、NEU、PCT水平显著高于非菌血症组,差异有统计学意义(P0.01)。PCT预测菌血症曲线下面积最大,为0.836(95%CI:0.767~0.904),显著高于WBC(0.676,95%CI:0.600~0.792)、NEU(0.696,95%CI:0.617~0.795),差异均有统计学意义(P0.01)。而WBC与NEU曲线下面积差异无统计学意义(P0.05)。当PCT临界值为0.43ng/mL时,基本排除菌血症(阴性预测值为94.7%);当PCT最佳临界值为2.27ng/mL时,其诊断菌血症的灵敏度为74.47%,特异度为90.00%,阳性预测值为83.3%,阴性预测值为84.0%。结论相比WBC、NEU,PCT在预测菌血症时显示出更好的价值,而且PCT检测时间短,可以为临床提供快速诊断,指导早期经验用药。
[Abstract]:Objective to investigate the value of procalcitonin (PCT) in predicting bacteremia.Methods A retrospective study was conducted on adult patients with first diagnosed bacteremia in clinical departments. WBC count and neutrophilic absolute value of neutrophilic PCT were recorded during the first blood culture.The predictive value of inflammatory indexes to bacteremia was evaluated by using the operating characteristic curve of subjects.Results during the study, 120 adult patients with newly diagnosed bacteremia were included, of whom 47 were in bacteremia group and 73 in non-bacteriaemia group.However, there was no significant difference in area under WBC and NEU curve (P 0.05).When the critical value of PCT was 0.43ng/mL, bacteremia was basically excluded (negative predictive value was 94.70.When the best critical value of PCT was 2.27ng/mL, the sensitivity, specificity, positive predictive value and negative predictive value of PCT were 74.47, 90.00,83.3and 84.0, respectively.Conclusion compared with WBC neutrography, PCT is more valuable in predicting bacteremia, and the detection time of PCT is shorter, which can provide rapid diagnosis for clinical practice and guide early experience in drug use.
【作者单位】：南方医科大学附属南海医院检验科;广东医学院检验系;
【分类号】：R515.3

【共引文献】