降钙素原对慢性肾病感染患者的诊断价值分析

Diagnostic value of procalcitonin for infections in patients with chronic kidney disease

目的探讨降钙素原(PCT)对慢性肾病感染患者的诊断价值,为临床治疗提供参考依据。方法采用横断面研究方法收集医院2014年1月-2016年5月慢性肾病患者191例,根据感染情况分为无感染组41例,局部感染组111例和血培养阳性组39例;无肾病患者186例,分为无感染组59例,局部感染组88例和血培养阳性组39例;分析各组之间血清PCT水平的差别,绘制ROC曲线评价PCT在慢性肾病患者中对感染的诊断价值。结果 PCT在慢性肾病患者中对鉴别有无感染、局部感染与血培养阳性的ROC曲线下面积分别是0.90和0.86,最佳临界值分别是0.55和19.39ng/mL;PCT对感染微生物种类也有一定的鉴别价值。结论在慢性肾病患者中,PCT对感染具有较高的诊断价值,但是其最佳临界值较无肾病者有所提高。

OBJECTIVE To study the diagnostic value of procalcitonin（PCT）for infections in patients with chronic kidney disease（CKD）,so as to provide evidence for clinical treatment.METHODS A total of 191 CKD patients were collected by cross-section study from Jan.2014 to May.2016,who were divided into 3groups according to their infection conditions,namely non-infection（n=41）,located infection（n=111）and positive blood culture（n=39）.The 186non-CKD subjects were divided into 3groups,namely non-infection（n=59）,located infection（n=88）and positive blood culture（n=39）.The levels of serum PCT in these groups were compared.A ROC curve was constructed to assess the value of PCT for infection in patients with CKD.RESULTS The areas under ROC curve for PCT detection in CKD patients about infection or not and local infection,and positive blood culture were0.90 and 0.86 respectively,and the best critical value were 0.55 and 19.39ng/mL,respectively.PCT was proved to be able for the certain value in identification differentiating kinds of microorganisms.CONCLUSIONPCT performs well in diagnosing infection in patients with CKD,in which the best critical value is higher comparing to patients without an impaired kidney.