降钙素原在急性细菌感染中的诊断价值

Value of procalcitonin in diagnosis of acute bacterial infection

目的探讨降钙素原在细菌感染中的诊断价值,为临床诊断与治疗提供参考依据。方法选取2012年2月-2014年12月医院收治的急性感染疾病患者97例为研究对象,将45例细菌感染患者作为观察组,52例非细菌感染患者作为对照组,采集患者静脉血进行降钙素原检查,观察两组患者降钙素原检测各项指标以及炎症分布,对患者诊断敏感性和特异性进行分析;采用SPSS18.0软件对数据进行统计分析。结果观察组降钙素原检测〈0.5、0.5~2.0、〉2.0ng/ml的患者分别为3、26、16例,对照组患者分别为43、8、1例,两组比较差异有统计学意义（P〈0.05）;患者各项炎症指标对于细菌敏感性、特异性的检测显示,45例细菌感染患者中白细胞总数达到临界值的为40例,中性粒细胞比值达到临界值的为37例,PCT水平达到临界值的为26例,而52例非细菌感染患者中白细胞总数达到临界值的为23例,中性粒细胞比值达到临界值的为20例,PCT水平达到临界值的为9例,PCT的敏感性及特异性均高于中性粒细胞比值以及白细胞总数。结论降钙素原检查对于细菌感染患者具有很好的特异性及敏感性,对于细菌感染患者的诊断检查具有较高的临床意义。

OBJECTIVE To explore the value of procalcitonin in diagnosis of bacterial infections so as to provide guidance for clinical diagnosis and treatment.METHODS A total of 97 patients with acute infections who were treated in the hospital from Feb 2012 to Dec 2014 were recruited as the study objects,45 patients with bacterial infections were assigned as the observation group,and 52 patients with non-bacterial infections were set as the control group.The level of procalcitonin was determined for the patients,the indicators and distribution of inflammations were observed by using the procalcitonin,the sensitivity and specificity in the diagnosis were analyzed,and the statistical analysis of data was performed with the use of SPSS18.0software.RESULTS There were 3patients with level of procalcitonin less than 0.5ng/ml in the observation group and 43 patients in the control group;there were26 patients with level of procalcitonin varying from 0.5to 2.0ng/ml in the observation group and 8patients in the control group;there were 16 patients with level of procalcitonin more than 2.0ng/ml in the observation group and1 patient in the control group,with statistical significance（P〈0.05）.The detection of sensitivity and specificity of the inflammatory indicators indicated that among the 45 patients with bacterial infections,there were 40 patients whose total white blood cell counts reached the critical value,37 patients whose neutrophils ratio reached the critical value,and 26 patients whose PCT level reached the critical value;among the 52 patients with non-bacterial infections,there were 23 patients whose total white blood cell counts reached the critical value,20 patients whose neutrophils ratio reached the critical value,and 9patients whose PCT level reached the critical value.The sensitivity and specificity of the PCT were higher than those of the neutrophils ratio and total while blood cell counts.CONCLUSIONThe procalcitonin has high specificity and sensitivity for the patients with bacterial infections,and it has great clinical significance in the diagnosis of the patients with bacterial infections.