血清降钙素原联合血培养连续检测对菌血症的诊断价值

Continuous Detection of Procalcitonin and Blood Culture in the United Diagnosis of Bacteremia

目的探讨血清降钙素原(Procalcitonin,PCT)联合血培养连续检测对菌血症的诊断价值。方法对76例菌血症(菌血症组)、32例肿瘤热(肿瘤组)和20例健康体检(健康对照组)在首诊时检测血清PCT,并对菌血症组进行血培养,每隔24 h重复检测以上两指标,比较3组的血清PCT水平,分析连续检测对菌血症的诊断价值,并对菌血症组应用抗生素前后血清PCT检测结果进行分析。结果首次检测PCT,3组的阳性率分别为82.89%、15.62%、0%,菌血症组与肿瘤组、健康对照组比较差异均有统计学意义(P<0.01);菌血症组首次血培养阳性率22.36%,随着培养次数的增加,血培养阳性率增加;菌血症得到控制者的PCT水平呈下降趋势。结论血清PCT联合血培养连续检测不仅可提高菌血症的诊断率,还可用于菌血症治疗效果及预后的判断,临床医生可根据发热时间的长短,选择最佳的血培养时间,以提高菌血症的确诊率。

Objective To discuss the value of continuous detection of procalcitonin and blood culture in the united diagnosis of bacteremia.Methods 76 patients with bacteremia（bacteremia group）,32 patients with tumor fever（tumor group） and 20 healthy subjects（healthy control group） were detected for the serum levels of PCT in the first visit.Bacteremia group received blood culture every 24 h and detected for both indicators.The levels of PCT in the 3 groups were compared,the diagnosis value of continuous detections was analyzed,and the results of PCT in bacteremia group were observed before and after antibiotics treatment.Results Positive rate of PCT in the 3 groups were 82.89%,15.62%,and 0 at the first test,and there were significant differences between the 3 groups（P0.01）;The positive rate of blood culture in bacteremia group was 22.36% at the first test,and it increased with the increase of blood culture;the level of PCT decreased when bacteremia was controlled.Conclusion Continuous detections of procalcitonin and blood culture can not only increase the diagnosis rate of bacteremia,but also can be used in the prognosis of bacteremia.Clinicians should choose the best time of blood culture to improve the diagnosis rate of bacteremia according to the the length of heat time.