重症监护室感染患者降钙素原诊断价值研究

Procalcitonin diagnostic value in infection in intensive care unit patients

目的探讨降钙素原(PCT)对重症监护室患者感染的诊断价值和临床意义。方法选择2011年9月—2012年3月某院重症监护室住院患者96例,测定其PCT、血清超敏C反应蛋白(HsCRP)和白细胞(WBC)计数水平,并进行统计分析。结果与非细菌感染组相比,细菌感染组患者血清中PCT浓度和HsCRP均升高,差异有统计学意义(Z值分别为-6.102、-3.918,均P<0.05);WBC计数比较,差异无统计学意义(Z=0.212,P>0.05)。PCT诊断感染的灵敏度为82.35%,特异度为67.86%,阳性预测值为86.15%,阴性预测值为61.29%;PCT、HsCRP、WBC三者ROC曲线下面积分别为0.898、0.755、0.581。结论 PCT预测细菌感染的敏感度和特异度较高,有助于早期发现危重患者的细菌感染,是诊断细菌感染价值较高的指标。

Objective To evaluate diagnostic value and clinical significance of procalcitonin （PCT）in infection in intensive care unit （ICU）patients.Methods 96 ICU patients in a hospital between September 2011 and March 2012 were selected for study,levels of patients’PCT,high-sensitivity C-reactive protein （HsCRP）and white blood cell （WBC）count were detected,statistical analysis were conducted.Results Compared with non-bacteria infected patients,serum PCT and HsCRP levels in all bacteria infected patients increased,the difference were significant （Z=-6.102;-3.918,both P 〈0.05 ）;WBC count was not significantly different（Z =0.212.P 〉0.05）.PCT sensi-tivity,specificity,positive predictive value,and negative predictive value for diagnosing infection was 82.35%, 67.86%,86.15%,and 61 .29% respectively;receiver operating characteristic （ROC）curve of PCT,HsCRP,and WBC was 0.898,0.755,and 0.581 respectively.Conclusion There are higher sensitivity and specificity of PCT to predict infection,which is helpful for early detection of infection in critically ill patients.