血清降钙素原定量检测在儿科血流感染诊断中的应用价值

Application value of procalcitonin quantitative detection in diagnosis of pediatric bloodstream infection

目的：探讨血清降钙素原（PCT）定量检测在儿科血流感染诊断中的价值。方法回顾性分析某院183例同时送检血液培养和 PCT 检测的结果，以血培养为金标准，把患者分为非血流感染组和血流感染组，比较两组间血清 PCT 浓度的差异。两组间 PCT 值差异比较采用 Mann-WhitneyU 检验，P ＜0．05为差异有统计学意义。结果非血流感染组血清 PCT 浓度为0．15（0．065～0．55）ng/mL，血流感染组血清 PCT 水平为1．11（0．505～8．975）ng/mL，两组间的血清 PCT 浓度差异有统计学意义（P ＝0．000）；以0．50 ng/mL 为界点，PCT 诊断的灵敏度为77．8％、特异度为73．3％，阳性预测值和阴性预测值分别为24．1％和96．8％。结论定量检测 PCT 可辅助快速排除或诊断血流感染，为避免抗菌药物的过度使用或早期抗感染治疗提供参考。

Objective To explore the application value of serum procalcitonin（PCT）quantitative detection in diagnosing pediat-ric bloodstream infection.Methods The results of 183 cases of blood culture and simultaneous PCT detection in a hospital from February to November 2013 were analyzed retrospectively.The patients were divided into the non-bloodstream infection group and the bloodstream infection group according to the blood culture results as the golden standard.The differences of serum PCT concen-tration were compared between the two groups by the Mann-Whitney U test.Results The serum PCT concentration was 0.15 （0.065-0.55）ng/mL in the non-bloodstream infection group and 1.11（0.505-8.975）ng/mL in the bloodstream infection group, the difference was statistically significant（P =0.000）;with 0.50ng/mL as the cut-off value of diagnosis,the sensitivity and the spe-cificity of PCT was 77.8% and 73.3% respectively,the positive and pegative predictive value of PCT was 24.1% and 96.8% re-spectively.Conclusion The quantitative detection of PCT can assist in rapidly diagnosing or excluding bloodstream infection and provides reference for avoiding the overuse of antibiotics or conducting the early anti-infection therapy.