早期血清降钙素原与细菌性血流感染病原菌相关性研究
发布时间:2019-04-19 07:14
【摘要】:目的:探讨早期血清降钙素原(PCT)水平与细菌性血流感染患者病原菌种类之间的相关性;同时,试图找到适宜的PCT临界值,为细菌性血流感染起始抗感染经验治疗方案的制定提供依据,减少不必要的广谱、超强、联合用药。方法:抽取某院2014年5月-2016年3月203例怀疑细菌性血流感染且在血培养前后12 h行血清降钙素原(PCT)检查的患者,按照革兰阳性菌和革兰阴性菌分组记录患者血清降钙素原(PCT),比较2组PCT水平的差异,用受试工作者曲线(ROC曲线)分析PCT在鉴别革兰阳性菌和革兰阴性菌血流感染的作用。结果:革兰阴性菌血流感染与革兰阳性菌血流感染早期PCT水平存在显著性差异(P0.05),且革兰阴性菌血流感染早期PCT明显高于阳性菌,中位数分别为3.92 ng·mL-1和0.62 ng·mL-1;2组患者受试工作者曲线(ROC曲线)显示PCT作为鉴别革兰阴性菌和革兰阳性菌血流感染有一定的意义(AUC为0.70,P0.05);以初次血清PCT1.81 ng·mL-1作为临界值时,对革兰阴性菌所致血流感染阳性预测值敏感性为62.3%,特异性为71.4%。结论:革兰阴性菌血流感染患者早期血清降钙素原(PCT)高于革兰阳性菌;PCT对革兰阴性菌和革兰阳性菌所致细菌性血流感染有一定的鉴别作用;在PCT高于1.81 ng·mL-1时,细菌性血流感染革兰阴性菌可能性较革兰阳性菌大;可结合初次PCT结果做出病原体的初步判断,为选择适宜的起始抗感染治疗方案提供帮助。
[Abstract]:Objective: to investigate the correlation between serum procalcitonin (PCT) level and pathogenic bacteria in patients with bacterial blood flow infection. At the same time, we tried to find a suitable critical value of PCT to provide the basis for the establishment of the initial anti-infection experience treatment scheme for bacterial blood flow infection, and to reduce unnecessary broad-spectrum, super-strong, combined use of drugs. Methods: from May 2014 to March 2016, 203 patients who were suspected of bacterial blood flow infection and underwent serum procalcitonin (PCT) examination 12 hours before and after blood culture were selected. The differences of serum procalcitonin (PCT), levels between the two groups were recorded according to gram-positive bacteria and gram-negative bacteria groups. The ROC curve was used to analyze the role of PCT in the identification of Gram-positive bacteria and Gram-negative bacteria blood flow infection. Results: there was a significant difference in PCT level between Gram-negative bacteria and Gram-positive bacteria in the early stage of blood flow infection (P0.05), and the PCT level of Gram-negative bacteria in the early stage of blood flow infection was significantly higher than that of the positive bacteria. The median values were 3.92 ng 路mL-1 and 0.62 ng 路mL-1, respectively. The workers' curve (ROC curve) showed that PCT could be used to distinguish Gram-negative bacteria from Gram-positive bacteria (AUC = 0.70, P0.05). When the initial serum PCT1.81 ng 路mL-1 was used as the critical value, the sensitivity and specificity of the positive predictive value for Gram-negative bacteria-induced blood flow infection were 62.3% and 71.4%, respectively. Conclusion: the serum procalcitonin (PCT) in the patients with Gram-negative bacterial blood flow infection is higher than that in the Gram-positive bacteria at the early stage, and PCT can differentiate the bacterial blood flow infection caused by Gram-negative bacteria and Gram-positive bacteria to a certain extent. When PCT was higher than 1.81 ng 路mL-1, Gram-negative bacteria was more likely to be infected by bacterial blood flow than Gram-positive bacteria, and the preliminary diagnosis of pathogens could be made according to the results of primary PCT, which would be helpful to select the appropriate initial anti-infection treatment scheme.
【作者单位】: 许昌市中心医院药学部;
【分类号】:R515
[Abstract]:Objective: to investigate the correlation between serum procalcitonin (PCT) level and pathogenic bacteria in patients with bacterial blood flow infection. At the same time, we tried to find a suitable critical value of PCT to provide the basis for the establishment of the initial anti-infection experience treatment scheme for bacterial blood flow infection, and to reduce unnecessary broad-spectrum, super-strong, combined use of drugs. Methods: from May 2014 to March 2016, 203 patients who were suspected of bacterial blood flow infection and underwent serum procalcitonin (PCT) examination 12 hours before and after blood culture were selected. The differences of serum procalcitonin (PCT), levels between the two groups were recorded according to gram-positive bacteria and gram-negative bacteria groups. The ROC curve was used to analyze the role of PCT in the identification of Gram-positive bacteria and Gram-negative bacteria blood flow infection. Results: there was a significant difference in PCT level between Gram-negative bacteria and Gram-positive bacteria in the early stage of blood flow infection (P0.05), and the PCT level of Gram-negative bacteria in the early stage of blood flow infection was significantly higher than that of the positive bacteria. The median values were 3.92 ng 路mL-1 and 0.62 ng 路mL-1, respectively. The workers' curve (ROC curve) showed that PCT could be used to distinguish Gram-negative bacteria from Gram-positive bacteria (AUC = 0.70, P0.05). When the initial serum PCT1.81 ng 路mL-1 was used as the critical value, the sensitivity and specificity of the positive predictive value for Gram-negative bacteria-induced blood flow infection were 62.3% and 71.4%, respectively. Conclusion: the serum procalcitonin (PCT) in the patients with Gram-negative bacterial blood flow infection is higher than that in the Gram-positive bacteria at the early stage, and PCT can differentiate the bacterial blood flow infection caused by Gram-negative bacteria and Gram-positive bacteria to a certain extent. When PCT was higher than 1.81 ng 路mL-1, Gram-negative bacteria was more likely to be infected by bacterial blood flow than Gram-positive bacteria, and the preliminary diagnosis of pathogens could be made according to the results of primary PCT, which would be helpful to select the appropriate initial anti-infection treatment scheme.
【作者单位】: 许昌市中心医院药学部;
【分类号】:R515
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