血清降钙素原对慢性肾病患者细菌感染的诊断评价

发布时间：2018-06-14 15:52

  本文选题：PCT + 慢性肾病　； 参考：《中华医院感染学杂志》2017年10期

【摘要】：目的探讨血清降钙素原(PCT)对慢性肾病患者细菌感染的诊断效果,为提升慢性肾病细菌感染患者的疗效提供科学依据。方法选取医院住院治疗的慢性肾病患者2 104例,根据是否发生院内细菌感染分为感染组116例和非感染组1988例,比较两组患者的血清PCT含量,计算PCT对慢性肾病患者细菌感染的灵敏度和特异性,分析感染组患者的病原菌分布以及相关病原菌的耐药性。结果两组患者的血清PCT含量差异有统计学意义(P0.05),经治疗后,与感染组治疗前相比,差异有统计学意义(P0.05);以PCT≥0.4ng/ml作为阳性标准,灵敏度80.2%(93/116),特异性97.6%(1941/1988);阳性预测值66.4%(93/140),阴性预测值98.8%(1941/1964);116例感染患者共培养出132株病原菌,感染单一菌株患者100例,混合感染患者16例,革兰阴性菌93株占70.5%,革兰阳性菌39株占29.5%;感染组患者革兰阴性菌中,铜绿假单胞菌对头孢唑林、红霉素、氧氟沙星、诺氟沙星、环丙沙星等耐药率较高,85.0%,对亚胺培南和美罗培南敏感,耐药率6.0%;大肠埃希菌对头孢唑林、红霉素、氧氟沙星、环丙沙星等耐药率较高,70.0%,对阿米卡星、亚胺培南、美罗培南敏感,耐药率13.0%;革兰阳性菌中,金黄色葡萄球菌对青霉素、替卡西林、阿莫西林、头孢曲松等耐药率较高,80.0%,对苄卡西林、万古霉素敏感,耐药率为0;表皮葡萄球菌对青霉素、替卡西林、阿莫西林、头孢曲松等耐药率较高,75.0%,对万古霉素敏感,耐药率为0。结论血清PCT的检测对于慢性肾病患者细菌感染早期的诊断指标具有较高的灵敏性和特异性,具有一定的临床诊断价值;慢性肾病患者感染以铜绿假单胞菌、大肠埃希菌为主,临床应根据药敏结果合理使用抗菌药物进行治疗,以提升感染患者的治疗效果和预后。
[Abstract]:Objective to investigate the diagnostic effect of serum procalcitonin (PCT) on bacterial infection in patients with chronic nephropathy, and to provide scientific basis for improving the efficacy of bacterial infection in patients with chronic nephropathy. Methods two hundred and four patients with chronic nephropathy treated in hospital were divided into two groups according to whether or not nosocomial bacterial infection occurred. The serum levels of PCT in the two groups were compared between the infected group (116 cases) and the non-infected group (1988 cases). The sensitivity and specificity of PCT to bacterial infection in patients with chronic nephropathy were calculated. Results there was a significant difference in serum PCT levels between the two groups (P 0.05). After treatment, the difference was statistically significant compared with that before treatment in the infection group, and the positive criteria were PCT 鈮，

本文编号：2018018