血清降钙素原检测对血流感染的诊断价值分析

Diagnostic value of procalcitonin quantitative detection in bloodstream infection

目的：探讨血清降钙素原（PC T ）检测对血流感染的诊断价值。方法回顾性分析2013年2～11月同时进行血培养和PC T检测的患者356例临床资料，以血培养检测结果将患者分为非血流感染组和血流感染组，比较两组间及革兰阴性菌感染组与革兰阳性菌感染组间血清PC T浓度的差异。结果非血流感染组、血流感染组血清PCT浓度分别为0．21（0．06～1．05）、4．36（0．78～15．60）ng/mL ，组间比较差异有统计学意义（P＜0．05）。革兰阴性菌与革兰阳性菌感染组血清PCT浓度分别为5．60（1．23～19．90）、2．04（0．59～9．05）ng/mL ，组间比较差异有统计学意义（ P＝0．041）。以0．50 ng/m L为临界值，PC T对血流感染的诊断灵敏度、特异度、阳性预测值和阴性预测值分别为83．1％、64．1％、41．3％、92．6％。结论 PC T定量检测用于血流感染的快速辅助诊断，也有利于血流感染病原菌类型的初步判断，能够为早期抗感染治疗方案的制订提供依据。

Objective To explore the diagnostic value of procalcitonin （PCT ） in bloodstream infection .Methods During Feb .2013 and Nov .2013 ,a total of 356 cases ,undertaking PCT and blood culture detection were divided in-to non-bloodstream infection group and bloodstream infection group ,according to results of blood culture .Mean-while ,cases in bloodstream infection group were divided into Gram-positive （G＋ ） infection group and Gram-negative （G-） infection group .The differences of PCT between each group were analyzed .Results Levels of PCT in non-bloodstream infection group and bloodstream infection group were 0 .21（0 .06 -1 .05） and 4 .36（0 .78 -15 .60）ng/mL ,with statistical difference （P〈0 .05） .Levels of PCT in G＋ infection group and G - infection group were 2 .04 （0 .59-9 .05）and 5 .60（1 .23 -19 .90）ng/mL ,with statistical difference （P〈0 .05） .When 0 .50 ng/mL was set as cut-off value of PCT for the diagnosis of bloodstream infection ,the sensitivity ,specificity ,positive and negative pre-dictive value were 83 .1% ,64 .1% ,41 .3% and 92 .6% .Conclusion Quantitative detection of PCT could be used for the rapid diagnosis of bloodstream infection ,which might be useful to identify the types of pathogenic bacteria and to provide evidence for making plans of early anti-infection therapy .