降钙素原在ICU医院获得性肺炎细菌感染的诊断价值

The diagnostic value of procalcitonin in ICU hospital-acquired pneumonia bacterial infections

目的:探讨降钙素原(PCT)对ICU医院获得性肺炎患者肺部细菌感染诊断的临床价值。方法:将医院2013年1月至2015年9月收治的ICU医院获得性肺炎肺部细菌感染患者69例,及单纯随机选取同期该院非细菌性肺部感染患者71例,对其血清、痰液PCT在入选时、2 d、7 d、治疗结束时的水平进行回顾性分析。结果:ICU医院获得性细菌肺炎组与非细菌肺炎组痰液降钙素原在入选时、2 d、7 d、治疗结束时水平比较,差异均无统计学意义(P〉0.05);ICU医院获得性细菌肺炎组与非细菌肺炎组血清降钙素原在入选时、2 d、7 d、治疗结束时水平比较依次为:(0.167±0.283)比(0.152±0.268)ng/ml(t=0.331,P=0.741)、(2.271±4.644)比(0.136±0.247)ng/ml(t=3.868,P=0.001)、(0.231±0.617)比(0.182±0.323)ng/ml(t=0.595,P=0.261)、(0.114±0.179)比(0.103±0.169)ng/ml(t=0.358,P=0.752)且2 d血清PCT的ROC曲线下面积AUC为0.921(P=0.001),灵敏度为87.5%,特异度为93.7%。结论:血清降钙素原在ICU医院获得性细菌性肺炎诊断中有较好的灵敏度和特异性,检测血清降钙素原在鉴别诊治医院ICU获得性细菌性肺炎中有较高临床价值。

Objective： To investigate the clinical value of procalcitonin （PCT） in the diagnosis of the pulmonary bacterial infections of patients with ICU hospital-acquired pneumonia.Methods： 69 cases of pulmonary bacterial infections of patients with ICU hospital-acquired pneumonia admitted in the hospital from January 2013 to September 2015, and 71 simple non-pulmonary bacterial infections patients selected randomly from the same period in the hospital were included in the study. Their serum and sputum PCT of the patients in both groups were ana- lyzed retrospectively at the time of selection, 2 days and 7 days after selection, and at the end of treatment. Re- sults： There were no statistical difference between both groups （P〈 0.05）; the respective level of PCT in the ICU hospital-acquired pneumonia bacterial infection group and non-bacterial pneumonia group at the time of selection, 2 d and 7 d after selection, and at the end of treatment were： （0.167 ±0.283） vs （0.152 ± 0.268） ng/ml （t = 0.331, P= 0.741）, （2.271 ± 4.644） vs （0.136 ± 0.247） ng/ml （t = 3.868, P= 0.001）, （0.231 ± 0.617） vs （0.182 ±0.323） ng/ ml （t = 0.595, P= 0.261 ）, and （0.114± 0.179）vs （0.103 ± 0.169） ng / ml （t = 0.358, P= 0.752）. Area under the curve （AUC） of ROC of serum PCT 2 d after being selected was 0.921 （P = 0.001）, its sensitivity was 87.5o/0 ity in monia, and specificity was 93.7%. Conclusion： Serum procalcitonin has better sensitivity and the diagnosis of pulmonary bacterial infections of patients with ICU hospital-acquir and the detection the serum procalcitonin will have diagnosis and treatment of ICU hospital-acquired bacterial a higher clinical value in the dif pneumonia. specific; ed pneu; ferential