血清降钙素原对急性肾盂肾炎的诊断价值

The Value of Serum Procalcitonin in the Diagnosis of Acute Pyelonephritis

目的:观察血清降钙素原(PCT)在急性肾盂肾炎患者中的变化及诊断价值。方法:对成都大学附属医院2012年8月至2014年8月156例急性肾盂肾炎患者进行回顾性分析。根据血清PCT水平分为脓毒血症组58例和非脓毒血症组98例。采用免疫荧光定量测定所有患者血清PCT及CRP水平,计算并分析PCT及CRP预测脓毒血症的敏感性、特异度指标,脓毒血症组患者采集血培养。结果:年龄大、低蛋白血症、贫血、营养状况差、糖尿病是急性肾盂肾炎合并脓毒血症的危险因素;脓毒血症组患者PCT、CRP和白细胞计数明显高于非脓毒血症组;脓毒血症组患者血培养阳性率82.76%,革兰阴性菌34株占70.83%,革兰阳性菌14株占29.17%;随着PCT水平升高,患者病死率显著升高。结论:血清PCT水平能早期正确鉴别诊断急性肾盂肾炎合并脓毒血症,血清PCT水平高低可作为急性肾盂肾炎患者的病情变化指标及预后评估依据。

Objective： To observe the effects of the Serum procalcitonin（ PCT） in patients with acute pyelonephritis. Methods： 156 patients of chengdu university affiliated hospital in August 2012 to August 2014 with acute pyelonephritis,on the basis of the level of PCT,were divided into two groups： sepsis group（ 58 cases） and non- sepsis group（ 98 cases）. The sepsis group gathered blood cultures,the serum PCT and CRP levels of the patients were taken with immune-fluorescence; PCT and CRP sensitivity,specific predictor in the sepsis group were calculated. Results： Age,hypoalbuminemia,anemia,malnutrition,diabetes were the risk factors in acute pyelonephritis with sepsis. The counts of PCT,CRP and WBC in Sepsis group were significantly higher than in non- sepsis group. Positive rate of blood culture was 82. 76% in sepsis patients,in which 34 strains of gram- negative bacteria accounted for 70. 83%,14 strains gram- positive bacteria accounted for 29. 17%. The mortality of patients was significantly increased with PCT level increased. Conclusion： Serum PCT level can correctly identify early diagnosis of acute pyelonephritis with sepsis,and can be used as the prognosis evaluation of patients with acute pyelonephritis.