降钙素原在肿瘤患者细菌血流感染鉴别中的临床价值研究

发布时间：2018-06-29 23:38

本文选题：降钙素原 + 血流感染　；参考：《中华医院感染学杂志》2017年02期

【摘要】：目的探讨血清降钙素原(PCT)水平对鉴别肿瘤患者细菌血流感染病原体的临床应用价值,为临床应用提供参考。方法收集2012年7月1日-2015年6月30日医院214例血培养结果阳性,并检测了血清PCT水平的肿瘤患者的临床资料;比较PCT水平、白细胞计数(WBC)和体温在革兰阴性菌、革兰阳性菌血流感染患者间的差异,同时根据受试者工作曲线(ROC)判断PCT的诊断价值。结果革兰阴性菌组和革兰阳性菌组PCT水平中位数分别为15.12、0.42ng/ml,革兰阴性菌组血清PCT明显高于革兰阳性菌组,组间比较差异有统计学意义(P0.01);两组患者WBC计数、体温差异无统计学意义;根据ROC曲线,当界值设定为0.54ng/ml时,血清PCT水平区分革兰阴性菌与革兰阳性菌所致血流感染的灵敏度为83.1%,特异度为79.5%。结论血清PCT水平对鉴别革兰阴性菌与革兰阳性菌引起的肿瘤患者的血流感染有一定的提示意义,可为临床早期使用抗菌药物提供参考。
[Abstract]:Objective to study the clinical application value of serum procalcitonin (PCT) level in differentiating bacterial blood stream infection pathogens in tumor patients. Methods from July 1, 2012 to June 30, 2015, 214 patients with positive blood culture results were collected, and the clinical data of tumor patients with serum PCT levels were detected, and the levels of PCT, white blood cell count (WBC) and body temperature were compared in Gram-negative bacteria. The difference between the patients with Gram-positive bacterial blood flow infection and the diagnostic value of PCT were evaluated according to the operating curve (ROC) of the subjects. Results the median levels of PCT in Gram-negative bacteria group and Gram-positive bacteria group were 15.12 ~ 0.42 ng / ml, respectively. The serum PCT level in Gram-negative bacteria group was significantly higher than that in Gram-positive bacteria group (P0.01), but there was no significant difference in WBC count and body temperature between the two groups. According to the ROC curve, when the threshold was set to 0.54ng/ml, the sensitivity and specificity of serum PCT to distinguish blood stream infection caused by Gram-negative bacteria and Gram-positive bacteria were 83.1 and 79.5 respectively. Conclusion the level of serum PCT may be helpful in differentiating the blood stream infection of tumor patients caused by Gram-negative bacteria and Gram-positive bacteria, and can provide a reference for early clinical use of antimicrobial agents.
【作者单位】：天津医科大学肿瘤医院检验科国家肿瘤临床医学研究中心天津市肿瘤防治重点实验室;
【基金】：国家自然科学基金(81402174)
【分类号】：R730.43

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