血清降钙素原与C-反应蛋白的医院感染诊断价值

Clinical value of serum procalcitonin and C-reactive protein in the diagnosis of healthcare-associated infection

目的 评估血清降钙素原（PCT）与G反应蛋白（CRP）对无明确感染灶医院感染患者的诊断价值.方法 对某院内外科怀疑医院感染的150例患者进行前瞻性研究,评估PCT与CRP对医院感染的诊断价值.结果 PCT和CRP医院感染诊断敏感性、特异性、阳性预测值、阴性预测值分别为（57.14％ vs 76.19％）、（89.15％vs48.06％）、（46.15％ vs 19.28％）、（92.74％vs 92.54％）.PCT较CRP具有高的阳性似然比（5.26 vs 1.46）.PCT的曲线下面积（AUC）为0.80（95％CI：0.68～0.91）,CRP的AUC为0.73（95％CI：0.63～0.82）;PCT医院感染的诊断截点值为7.49 ng/mL,CRP为39.01mg/L.结论 PCT和CRP均能作为诊断医院感染有临床指导意义的指标,PCT比CRP具有更高的特异性及阳性预测值.

Objective To evaluate the value of serum procalcitonin （PCT） and C-reactive protein （CRP） for detecting healthcare-associated infection（HAD in hospitalized patients without localizing signs of infection. Methods 150 patients with suspected HAI were conducted prospective study, diagnostic value of PCT and CRP in the detection of HAI were evaluated. Results The sensitivity, specificity, positive predictive value and negative predictive value of PCT and CRP were （57. 14% vs 76. 19%）, （89. 15% vs 48. 06%）, （46. 15% vs 19. 28%）, and （92. 74% vs 92. 54%）,respectively. Positive likelihood ratio of PCT was higher than CRP （5.26 vs 1.46）. The area under the curve（AUC）was 0. 80 （95% CI： 0. 68 - 0. 91） for PCT and 0. 73 （95% CI： 0. 63 - 0. 82） for CRP;the optimal cutoff value was 7. 49 ng/mL for PCT and 39. 01 mg/L for CRP. Conclusion PCT and CRP are valuable for diagnosing HAI, the specificity and positive predictive value of PCT are higher than CRP.