血清降钙素原在诊断慢性肾脏病合并细菌感染中的临床价值

Clinical value of serum procalcitonin in the diagnosis of bacterial infection in patients with chronic kidney disease

目的:探讨血清降钙素原(PCT)在慢性肾脏病(CKD)合并细菌感染中的诊断价值。方法:将在南京大学医学院附属鼓楼医院肾内科住院的153例CKD患者,分为细菌感染组70例与非感染组83例,了解肾功能对PCT水平的影响,并比较组间PCT、C反应蛋白水平的差异,分析它们对细菌感染诊断的特异度和灵敏度。结果:非感染组中,非透析患者血清PCT水平与肾功能呈负相关关系。血液透析(HD)患者的PCT水平显著高于任何一期CKD及腹膜透析(PD)患者(P<0.05)。细菌感染组的PCT水平显著高于非感染组(P<0.05)。ROC曲线分析表明PCT较CRP有着较好的诊断特异性。结论:显著升高的血清PCT水平可作为临床CKD患者诊断细菌感染的有用指标。

Objective： To investigate the significance of serum procalcitonin（ PCT） in the diagnosis of bacterial infection in patients with chronic kidney disease（ CKD）. Methods： A total of 153 patients with CKD treated in Drum Tower Hospital Affiliated to Medical College of Nanjing University were involved in this study. They were divided into bacterial infection group（ 70 patients） and non-infection group（ 83 patients）. The influence of renal function on the level of PCT was investigated,and the levels of PCT and C-reactive protein between the two groups were compared. The specificity and sensitivity of these parameters in the diagnosis of bacterial infection were analyzed. Results： In the non-infection group,PCT was negatively correlated with renal function evaluated by estimated glomerular filtration rate. Hemodialysis patients had a significantly higher level of PCT than non-dialysis patients and peritoneal dialysis patients（ P〈0. 05）. The PCT levels in bacterial infection group were significantly higher than those in the non-infection group（ P〈0. 05）. ROC analysis showed that PCT had a better diagnostic specificity than CRP. Conclusion： Our research revealed that significantly elevated serum PCT can be used as a valuable marker for the diagnosis of bacterial infection in patients with CKD.