血清降钙素原在诊断早期产褥感染中的意义

Value of serum PCT for diagnosis of early puerperal infection

目的探讨血清降钙素原(PCT)对于早期鉴别诊断产褥感染的临床价值。方法选取2013年6月至2016年5月在广州市妇女儿童医疗中心产科确诊的150例产褥感染患者作为感染组,另选未发生产褥感染妇女100例作为对照组,比较两组血清PCT的变化趋势,并采用受试者工作曲线(ROC)分析PCT鉴别诊断早期产褥感染的诊断学效能。结果产后0h,感染组和对照组的血清PCT水平差异无统计学意义(t=0.823,P>0.05),产后12h、24h、48h、72h,感染组的PCT水平呈逐渐升高的趋势,均显著高于同时间点对照组的血清PCT水平,差异均有统计学意义(t值分别为25.61、42.167、54.004、51.753,均P<0.05)。产后72h血清PCT水平鉴别诊断产褥感染的灵敏度为76.00%、特异度为85.00%、漏诊率为24.00%、误诊率为15.00%、ROC曲线下面积AUC值为0.862。结论密切关注产后血清PCT水平变化,对于早期鉴别诊断产褥感染具有一定的临床价值。

Objective To investigate the clinical value of serum procalcitonin（ PCT） for diagnosis of early puerperal infection. Methods From June 2013 to May 2016 a total of 150 cases diagnosed with puerperal infection were selected in infection group from Guangzhou Women and Children Medical Center. Another 100 cases without puerperal infection were selected in control group. The trend of serum PCT was compared between two groups,and the receiver operating characteristic（ ROC） curve was used to analyze the effectiveness of PCT on diagnosis of early puerperal infection. Results Postpartum 0h,serum PCT levels were not statistically significant between two groups（ t = 0. 823,P〈0. 05）. After 12 h,24h,48 h and 72 h,PCT level appeared a trend of rising in infection group,and it was significantly higher than that at the same time points in the control group. The differences were statistically significant（ t value was 25. 61,42. 167,54. 004 and 51. 753,respectively,all P〈0. 05）. At postpartum 72 h,the sensitivity,specificity,missed diagnosis rate and misdiagnosis rate was 76. 00%,85. 00%,24. 00% and 15. 00%,respectively. AUC value was 0. 862. Conclusion Paying close attention to changes in the level of serum PCT for early diagnosis of postpartum puerperal infection has certain clinical value.