降钙素原在亚急性甲状腺炎鉴别诊断中的应用

Application of procalcitonin detection in differential diagnosis of sub-acute thyroiditis patients

目的探讨降钙素原（PCT）检测在鉴别亚急性甲状腺炎伴发热患者是否合并细菌感染时的应用价值。方法选择2012—2013年确诊为亚急性甲状腺炎患者92例，根据临床表现及细菌培养结果确诊亚急性甲状腺炎伴发热患者是否合并细菌感染，将其分为细菌感染组34例，非细菌感染组58例，同时设立健康对照组20名，测定所有患者血清降钙素原，全血白细胞计数及中性粒细胞比例，数据采用SPSS13．0软件进行统计分析。结果细菌感染组全血白细胞计数、中性粒细胞比例及血清降钙素原水平，分别为（12．80±2．38）×10^9／L、（83．9±6．3）%、（3．24±1．27）ng／ml，均明显高于无细菌感染组的（6．17±1.43）×10^9／L、（61．5±5．4）％、（0．32±0．19）ng／ml，差异有统计学意义（P〈0．05）；无细菌感染组血清降钙素原水平与正常对照组比较，差异无统计学意义；白细胞正常但中性粒细胞比例升高细菌感染组降钙素原阳性率80．0％，明显高于无细菌感染组的8．3％，差异有统计学意义（P〈0．05）；所有患者均未应用糖皮质激素治疗，患者体温降至正常的时间为3～7d，约1～2个月临床痊愈，随访两个月无复发。结论降钙素原可以作为鉴别亚急性甲状腺炎伴发热患者是否合并细菌感染的重要指标。

OBJECTIVE To investigate the value of PCT detection in the differential diagnosis of fever patients with sub-acute thyroiditis to make sure whether they have bacterial infection or not. METHODS A total of 92 patients with sub-acute thyr0iditis were collected during 2012 to 2013. Among them, 34 cases of bacterial infection group, 58 cases of non-bacterial infection group and 20 cases of normal control in fever patients with sub-acute thyroiditis were included according to whether they have bacterial infection or not. The levels of serum PCT, white blood cells count and neutrophils proportion were measured in all cases. SPSS13.0 software was used for statistical analysis. RESULTS The white blood cells count, neutrophils proportion and the serum PCT level were （12.80_＋ 2.38） X 109 / L, （83.9 ~ 6. 3 ） ~ and （ 3.24 ＋ 1.27 ） ng/ml respectively, which were all significantly higher than those in the non-bacterial infection group which were （6.17±1.43） × 10^9/L, （61.5±5.4）% and （0.32±0.19） ng/ml,and the different was statistically significant （P〈0.05）. There was no significant difference in levels of serum PCT between the non-bacterial group and the control group. White blood cells count was normal and neutrophils proportion increased. In bacterial infection group, the positive rate of procalcitonin was 80.0 % which was significantly higher than that in non-bacterial infection group and the difference was statistically significant（P 〈0.05）. All patients did not use prescriped glucocorticoids and after 3 to 7 days the fever degree could drop to normal, about 1 to 2 months patients could be cured without recurrence in the following 2 months. CONCLUSIONS The serum PCT may serve as an important indicator in the differential diagnosis of fever patients with sub-acute thyroiditis to make sure whether they have bacterial infection or not.