摘要
目的：探讨血清降钙素原（procalcitonin，PCT）与不同致病菌感染及感染程度的关系。方法：按照ACCP／SCCM（美国胸内科医师学会／危症监护医学学会）关于脓毒症的相关定义，将感染性疾病分为确诊脓毒症和非脓毒症，并经微生物培养确认感染微生物。采用免疫荧光定量检测法（ELFA）测定患者血清PCT含量，比较在不同致病菌所致感染之间差异，以及脓毒症组与非脓毒症组间差异。结果：以PCT≥0．05ng／ml为阳性域值，PCT阳性率为89％（34／38），而不同致病菌所致感染组间PCT含量无显著性差异（P〉0．05）。以PCT≥2ng／ml为脓毒症阳性域值，脓毒症患者与非脓毒症患者血清PCT浓度有极显著性差异（P〈0．01）。PCT对脓毒症的临床诊断灵敏度63．6％（14／22），特异性为100％（16／16）。结论：血清PCT是鉴别细菌感染引发脓毒血症快捷、敏感、准确的检测手段，优于血清CRP检测；但不能判断为何种细菌感染。目前脓毒症是重症监护中死亡的重要原因，应加强PCT和细菌培养、血常规的互利互补和动态跟踪，提高临床对感染诊断和治疗的准确性。
To detect significance of the quantitative PCT in infection and degree of different pathogens. Methods According to ACCP/ SCCM （ American College of Chest Physicians / Society of Critical Care Medicine） definition of sepsis, The infectious diseases could be classiafiod into the sepsis and the Non - sepsis. Pathogen infection could be confirmed by microorganism culture. Method with the combination of immune sandwich and final fluorescent detection （ ELFA）, we determined the PCT concentration in patients＇ blood serum quantitatively. Combined with the clinical condition and blood routine examination of patients, we compared the differences in the test results of the each three pathogenic germ group, Gram - negative bacillus, Gram - positive cocci and fungi, also the sepsis and the Non - sepsis. Results ： With PCT 〉 0.05 ng/ml in positive region, the PCT positive rate was 89% （34/38）. There were no obvious differences in the PCT test outcoming among the three kinds of pathogenic germ（P 〉0.05）. With PCT 〉 2ng/ml in positive region, the sepsis patients and the Non-sepsis ones had a marked difference in the PCT test resuhs（P 〈0.01）. PCT had high sensitivity to sepsis clinical diagnosis was 59% （13/22） ,and the characteristic clinical manifestations was 100% （13/13）. Conclusions： PCT is a speedy, sensitive, precise inspecting method which is used to detect sepsis caused by bacterial infection. But the category of the pathogens cannot be identified by the PCT concentration in patients＇ blood serum. Currently, sepsis is the primary cause of death in Intensive Care Therapy. In the event that only PCT concentration cannot determine the type of infected bacteria, the combination of PCT and germicuhure and blood routine examination should be given high concern, which can help to improve the accuracy in clinical diagnosis and treatment.
