血清降钙素原在下呼吸道感染疾病中的诊断与应用

Application of Procalcitonin Test in Lower Respiratory Tract Infection

目的探讨血清降钙素原(PCT)检测在早期诊断下呼吸道细菌感染中的作用。方法应用免疫荧光定量检测方法对医院诊治的98例呼吸系统感染患者进行检测,并对部分患者的治疗进行监测,同时与患者的白细胞计数(WBC)、C反应蛋白(CRP)检测进行比较。结果以血清PCT 0.12 ng/mL为阳性阈值,PCT对呼吸道细菌性感染诊断的灵敏度为96.82%,特异度为96.66%,血清CRP 20 mg/L为阳性阈值,灵敏度为89.79%,特异度为47.05%,血WBC 10.55×109/L为阳性阈值,灵敏度为60.32%,特异度为63.33%,细菌感染组PCT浓度较非细菌感染组明显升高(P<0.001)。结论PCT检测在呼吸系统细菌感染性疾病中其灵敏度和特异度均明显高于传统的CRP及WBC检测,可快速对细菌感染进行早期诊断,对判断感染的严重程度及预后有重要的临床参考价值,有助于抗菌药物的合理使用。

OBJECTIVE To evaluate the diagnosis value of the procalcitonin （PCT） test in the lower respiratory tract infection （LRTI）, and to provide the application of PCT in the bacterial infectious disease. METHODS Procaleitonin concentrations were measured using the quantitative immunofluoreseenee test in 93 patients and the results were compared with the levels of C reactive protein （CRP） and white blood cell count （WBC）. Samples were collected and divided into 2 groups, one including 63 cases （bacterial infected group） the other including 30 cases （non-haeterial infected group） corresponding to their clinical diagnosis （temperature, heart rate,bacteremia culture, CRP,WBC count）. RESULTS The levels of PCT in bacterial infected group were significantly higher than in non-bacterial infected group （P〈0. 001）. The threshold of PCT concentration was 0. 12ng/ml, and the sensitivity were 96.82% and specificity 96.66%. The threshold of CRP was 20 mg/L, with sensitivity 89.79 % and specificity 47.05%. The threshold of WBC was 10.55 × 10^9/L with sensitivity of 60.32% and specificity of 63.33%. PCT was significantly better and specific for bacterial infection, diagnosis than CRP or WBC count. CONCLUSIONS Procaieitonin test is an a important marker for early diagnosis of infection in LRTI. In patients with bacterial infection the PCT is an important index for assessment of severity of disease and prognosis. The PCT test can improve the accuracy of clinical diagnosis.