降钙素原在结核病诊断的价值

Value of procalcitonin in the diagnosis of tuberculosis

目的探讨血清降钙素原在结核病的鉴别诊断及疗效观察的价值。方法收集结核患者和健康对照者的血清,采用ELISA法定量检测血清中的降钙素原浓度,绘制受试者工作特征曲线判断降钙素原在结核病的诊断和疗效价值。结果结果显示,活动性肺结核组降钙素原浓度高于其他结核组和健康对照组(P<0.05),肺外结核组高于非活动性肺结核组和健康对照组(P<0.05)。受试者工作特征曲线分析确定降钙素原诊断活动性肺结核的临界值为0.15ng/mL,以此为诊断临界值其敏感度、特异性分别为76.9%和81.2%。活动性肺结核患者经有效治疗后,血清降钙素原含量明显降低。结论降钙素原可作为活动性肺结核辅助诊断和治疗效果的判断指标。

Tuberculosis control has not benefited substantially from technological development over the past 100 years.The diagnostic tools are largely the same as in the early nineteenth century.Procalcitonin is a useful marker for severe systemic bacterial infections such as sepsis.Research on PCT level in the TB infection is limited.The aim of the study was to evaluate the diagnostic and prognostic value of PCT in the TB infection.The patients with the TB infection were divided into three groups： active pulmonary TB,non-active pulmonary TB,and extrapulmonary TB.Serum PCT level was measured by enzyme-linked immunosorbent assay（ELISA）.The diagnostic and prognostic values of PCT in the TB infection were determined by receiver operating characteristic curve（ROC）.The ELISA results showed that level of PCT was significantly increased in the active pulmonary TB group compared with the other TB groups and the healthy controls（P0.05）.At the same time,in the extrapulmonary TB group,significantly elevated PCT level was found in comparison to the non-active pulmonary TB group and healthy controls（P0.05）.ROC analysis revealed that optimal discrimination between the active pulmonary TB and the other TB disease could be performed at a suggested cut-off point of 0.15 ng/mL,with a sensitivity of 76.9% and specificity of 81.2%.After effective treatment,level of PCT in the active pulmonary TB group was decreased significantly.It is suggested that PCT might have diagnostic and prognostic value in the active pulmonary TB infection.