利用降钙素原判断细菌感染的临床符合性分析

Evaluation of using procalcitonin in the diagnosis of bacterial infection

目的通过实验室数据和临床综合诊断分析血清降钙素原(PCT)在判断细菌感染中的临床符合性。方法对诊断感染的常规指标C反应蛋白(CRP)、白细胞计数(WBC)、中性粒细胞比例(N%)和细菌培养与PCT进行判断感染的临床符合性分析,再对PCT与临床综合诊断结论进行统计学分析来判断感染和非感染,以及不同部位感染的差异。结果当PCT大于0.5 ng/ml时与常规指标的符合性大于92%,而且随着PCT的增大符合性进一步增加;PCT与常规指标之间除CRP外均差异有统计学意义(P<0.01);PCT的ROC曲线下面积大于全部常规指标;细菌感染与非感染组间PCT差异有统计学意义(P<0.01),但对肿瘤合并感染情况较难判断;PCT全身感染与局部感染之间除伤口感染外均差异有统计学意义(P<0.01),但在不同部位间差异无统计学意义。结论 PCT与临床广泛应用判断感染的常规指标具有较好的吻合性,PCT在判断细菌感染方面选各医院适用的CUTOFF值能起到很好的作用,可以替代常规指标。

Objective To evaluate the clinical values of using procalcitonin （PCT） in the diagnosis of bacterial infection through a comparative analysis on laboratory data and clinical diagnosis. Methods The level of procalcitonin was compared with routine items including C-reactive protein, white blood cell count, percentage of neutrophil and bacteria culture in judging clinical bacterial infection. Be used for discriminating bacterial infection and non-bacterial infection with statistic method. Meanwhile, be used for discriminating different position. Results The consistency between procalcitonin and routine items is greater than 92%, when value of procalcitonin is above 0.5 ng/ml, furthermore the consistency increases following with value of procalcitonin. There is obvious difference （P〈0.01） between proealeitonin and routine items except C-reactive protein. Area under the ROC curve of PCT is bigger than other routine items. There is obvious difference （P〈0.01） of procaleitonin between bacterial infection and non-bacterial infection except cancer with infection. There is a obvious difference of proealcitonin between pantasomatous infection and local infection except alimentary tract, but there is no difference among different position. Conclusions There is a good consistency between procalcitonin and routine items. Procalcitonin can be a optimal substitute of routine items with compatible CUTOFF value.