定量检测降钙素原在危重患者感染诊断及其预后判断中的临床评价研究

Clinical evaluation of quantitative detection of procalcitonin in diagnosis critically infected patients and prediction of prognosis

目的探讨定量检测降钙素原(PCT)在危重患者感染临床诊断及其预后判断中的临床价值,为临床诊断提供科学依据。方法选取2010年2月-2013年6月重症监护病房收治的危重患者114例,按照感染的程度分为重症感染组29例和一般感染组89例,同时选取非感染性疾病45例患者为对照组,所选患者均采用荧光酶免疫法定量检测降钙素原水平,并对患者血液或痰、尿或创面分泌物等标本进行细菌培养,总结两者间的关系并观察其预后。结果重症感染组患者PCT浓度平均为(64.27±4.17)ng/ml,明显高于一般感染组(18.66±11.25)ng/ml和对照组(1.26±1.25)ng/ml;重症感染组患者PCT检测阳性率与细菌培养阳性率分别为100.0%、88.0%,明显高于一般感染组的87.6%、85.4%,差异有统计学意义(P<0.05);一般感染组患者较重症感染组预后效果良好。结论在危重患者感染诊断及预后判断过程中,加强血清PCT的定量检测作为一个重要的指标,对临床诊断及预后改善具有重要的参考和指导意义。

OBJECTIVE To investigate clinical value of the quantitative determination of proealeitonin in diagnosis of critically infected patients and prediction prognosis, to provide a scientific basis for clinical diagnosis. METHODS A total of 114 critically ill patients from ICU from Feb. 2010 to Jun. 2013 were selected and divided according to the degree of infection, into severe infection group （29 cases） and general infection group （89 cases）, while 45 cases of non-infectious selected as controls group, and all selected patients were treated with fluorescent enzyme immunoassay for quantitative detection of procaleitonin levels. The patient＇s blood, collected sputum, urine or wound secretions and other specimens were cultured for summarizing the relationship between the two and observe its prognosis. RESULTS The average PCT concentration in severe infection group was （64. 27 !-4. 17）ng/mL, clearly higher than that in general infection group （18.66 _4_ 11.25）ng/mI and control group 1.26 ＋ 1.25）ng/ml. The positive defection rate of PCT and the positive bacterial culture rate in severe infection group were 100% and 88%, which were significantly higher than those in the general infection group 87.6 % and 85.4% （P〈0.05）. The prognosis effect of patients from general infection group was better than patients from severe infection group. CONCLUSION For diagnosis and prognosis judgement in critically infected patients, detection of serum PCT should be strengthened, whin as an important indicator, is an important reference and guidance.