血清降钙素原对危重病人细菌感染的诊断价值

Value of serum procalcitonin in the diagnosis of bacterial infections in the critical patients

目的评价血清降钙素原(PCT)对危重病人感染诊断和鉴别诊断的临床价值。方法53例危重病人按细菌感染、非细菌感染分为两组,采用微量双夹心免疫发光法测定血清PCT水平。结果细菌感染组PCT水平明显高于非细菌感染组(χ2=10·05,P<0·05)。随血清PCT浓度升高,其对危重病人感染诊断的敏感度降低、特异度增高;以1·5ng/ml为阳性诊断标准时,Youden指数和诊断符合率分别为0·65和83·0%,明显高于以1ng/ml和2ng/ml为阳性诊断标准时。结论血清PCT检测对危重病人细菌感染的早期诊断、鉴别诊断及指导临床治疗具有重要意义。

Objective To evaluate the clinical value of serum procalcitonin （PCT） in the diagnosis and differentiation of bacterial infections in the critically ill patients. Methods A total of 53 critical patients were divided into bacterial infection group and nonacterial irffection group. Serum PCT was measured by immunoluminometric assay. Results PCT of bacterial infection group was significantly higher than that in non-bacterial infection group （χ^2=0. 05, P〈0.05）. With increase in the concentration of PCT, its sensitivity was lower, but its specificity was higher. With PCT≥1.5 ng/ml as the cutoff point for positive, Youden＇s index and agreement were highest. Conclusions Serum PCT has clinical values in the diagnosis, differentiation and therapy of bacterial infections in the critical patients.