降钙素原在败血症中的诊断意义

发布时间：2018-04-24 14:27

本文选题：败血症 + 降钙素原　；参考：《中华医院感染学杂志》2015年02期

【摘要】：目的通过分析血清降钙素原(PCT)在由革兰阴性菌和革兰阳性菌引起败血症患者中的血清浓度,明确PCT对不同菌引起败血症的诊断意义,为早期治疗提供理论依据。方法搜集医院发热患者145例,血培养阳性患者74例,阴性患者71例;血培养阳性患者中革兰阴性菌和革兰阳性菌各37例,比较不同组间PCT血清浓度。结果革兰阳性菌引起败血症以表皮葡萄球菌为主占21.62%,革兰阴性菌引起败血症以肺炎克雷伯菌为主占18.92%;通过比较3组间PCT表达水平,发现革兰阴性菌组PCT血清浓度明显高于革兰阳性菌组和血培养阴性组患者,而革兰阴性菌或革兰阳性菌不同菌间PCT表达差异无统计学意义;通过ROC曲线分析发现PCT诊断革兰阴性菌引起败血症的灵敏度为81.0%、特异性为93.0%、曲线下面积为92.0%。结论 PCT对于革兰阴性菌引起败血症具有较高的诊断价值,而对于非败血症及革兰阳性菌引起的败血症诊断意义不大。
[Abstract]:Objective to analyze the serum concentration of serum procalcitonin (PCT) in patients with septicemia caused by Gram-negative bacteria and Gram-positive bacteria, to determine the diagnostic significance of PCT for septicemia caused by different bacteria, and to provide theoretical basis for early treatment. Methods 145 patients with fever, 74 patients with positive blood culture, 71 patients with negative blood culture, 37 patients with Gram-negative bacteria and 37 patients with Gram-positive bacteria were collected. The serum concentrations of PCT were compared between different groups. Results the septicemia caused by Gram-positive bacteria was mainly caused by Staphylococcus epidermidis and the septicemia caused by Gram-negative bacteria was mainly accounted for by Klebsiella pneumoniae. It was found that the serum concentration of PCT in Gram-negative bacteria group was significantly higher than that in Gram-positive bacteria group and blood culture negative group, but there was no significant difference in PCT expression between Gram-negative bacteria and Gram-positive bacteria. ROC curve analysis showed that the sensitivity of PCT in the diagnosis of septicemia caused by Gram-negative bacteria was 81.0, the specificity was 93.0, and the area under the curve was 92.0. Conclusion PCT has high diagnostic value for septicemia caused by Gram-negative bacteria, but not for non-septicemia and Gram-positive bacteria.
【作者单位】：解放军302医院肝脏肿瘤与研究中心二科;
【基金】：国家自然科学基金资助项目(81272330) 军队十二五基金资助项目(CWS12J024)
【分类号】：R515.3

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