降钙素原在不同危重患者中鉴别感染的能力

The Ability to Identify Infection Among Different Critical Patients

目的目前降钙素原（PCT）是一种广泛应用于临床的感染标志物,但其诊断能力受多种因素干扰,为此,本研究前瞻性观察PCT在不同危重病患者中的表现,以综合评价其诊断价值。方法自2015年3~9月,连续性纳入危重病患者,主要纳入呼吸科、脑外科、普外科3个科室患者,记录患者各项临床资料,并测定其降钙素原的表达水平。结果共171名患者纳入研究,其中呼吸科75名、脑外科61名、普外科35名,PCT诊断感染的受试者工作特征（ROC）曲线下面积在3个科室分别为0.78、0.54、0.89,总体患者的ROC曲线下面积为0.69。结论 PCT在不同种类重症患者中诊断感染能力存在差异,诊断价值：普外科〉呼吸科〉脑外科,因此,用PCT值判断感染应具体分析、动态观察。

Objective Procaleitonin （PCT） is a widely used clinical infection marker today, however, which diagnostic capacity is influenced by many factors. Thus, we conducted this prospective research to watch PCT performance in different critical patients, in order to comprehensively evaluate diagnostic value of PCT. Methods Critical patients who admitted from March to September 2015, from pneumology department, neurosurgery and general surgery department, were included in our study. Then we recorded clinical data of patients and measured PCT expression level of these patients. Results Total 171 patients were included in this research, including 75 patients of pneumology department, 61 of neurosurgery and 35 of general surgery department. The area under the receiver operating characteristic curve （ROC） for PCT diagnosing infection of patients, who came from above-mentioned three departments, were 0.78, 0.54 and 0.89 respectively, in addition, that of all the patients is 0.69. Conclusion PCT showed different diagnosis capacity among diverse population of critical patients, with diagnostic values： general surgery department〉pneumology We suggest that understanding PCT value need a continuous observation and a specific analysis.