血清降钙素原在烧伤患者细菌性感染诊断中的价值

Value of serum procalcitonin in diagnosis of bacterial infection in burn patients

目的探讨血清降钙素原(PCT)在烧伤患者细菌性感染诊断中的临床价值。方法 169例烧伤患者经血培养、分泌物和穿刺液培养等病原学检查确认细菌性感染96例,非细菌性感染73例,2组患者同时进行PCT、WBC和超敏C反应蛋白(hsCRP)检查,比较这3项指标在细菌性感染诊断中的价值,并进一步研究PCT浓度水平与烧伤程度的关系。结果细菌性感染组烧伤患者血清PCT、WBC和hs-CRP浓度水平明显高于非细菌性感染组(P<0.05)。PCT诊断细菌性感染敏感性为90.63%,特异性为89.04%,阳性预测值为91.58%,阴性预测值为87.84%,PCT对细菌性感染的诊断效能明显高于其他两项炎症指标,PCT的浓度水平与烧伤患者的烧伤程度成正相关。结论细菌性感染的烧伤患者血清PCT、WBC和hs-CRP水平明显升高,PCT作为诊断细菌性感染标志物具有更好的敏感性及特异性,优于WBC和hs-CRP两项炎症指标。

Objective To explore the clinical significance of procalcitonin（PCT）in the diagnosis of bacterial infection in burn patients.Methods Among 169 burn patients,96 cases were bacterial infection confirmed by blood,secretion and puncture fluid culture and 73 cases were non-bacterial infection.PCT,WBC and hyper sensitive C reactive protein（hs-CRP）were detected.The diagnostic values in bacterial infection were compared among these 3indexes and the relationship between PCT level and burn degree was further studied.Results Serum PCT,WBC and hs-CRP levels in the bacteria infection group were obviously higher than those in the non-bacterial infection group（P〈0.05）;the sensitivity,specificity,positive predictive value and negative predictive value of PCT were 90.63%,89.04%,91.58%and 87.84%respectively,which indicated that PCT had higher diagnostic value than WBC and hsCRP.The PCT level was positively correlated with the degree of burn degree.Conclusion Serum PCT,WBC and hs-CRP in the burn patients with bacteria infection are greatly increased.PCT as the marker of bacterial infection has the higher sensitivity and specificity than WBC and hs-CRP in the diagnosis of bacteria infection.