降钙素原在尿脓毒症早期诊断中的应用价值

Applicative value of procalcitonin in the early diagnosis of urosepsis

目的探讨降钙素原(PCT)在早期诊断尿脓毒症的应用价值。方法收集2015年1月至2016年1月我院尿路感染患者55例,其中尿脓毒症24例,非尿脓毒症31例。采用降钙素原(PCT)、血白细胞(WBC)、C反应蛋白(CRP)作为检测的炎症指标,比较它们的差异,绘制受试者工作曲线(ROC)。结果尿脓毒症组PCT显著高于非尿脓毒症组,组间比较差异有统计学意义(P<0.01);尿脓毒症组血WBC、CRP高于非尿脓毒症组,但组间差异无统计学意义(P>0.05)。ROC曲线分析显示,尿脓毒症组PCT的曲线下面积(AUC)为0.981,高于血WBC、CRP(AUC分别为0.611、0.661);PCT为3.42μg/L时,诊断尿脓毒症的敏感性为86.1%,特异性为91.3%,优于血WBC、CRP炎症指标。结论 PCT对尿脓毒症的早期诊断具有良好敏感性和特异性,可做为尿脓毒症患者的常规检测指标。

Objective To investigate the applicative value of procalcitonin（PCT）in the early diagnosis in urosepsis.Methods A total of 55 patients with urinary tract infection treated during Jan.2015 and Jan.2016 were enrolled,including24 patients with urosepsis,and 31 with non-urosepsis.serum concentrations of PCT,white blood cell（WBC）and C-reactive protein（CRP）were compared between the urosepsis group and non-urosepsis group.The receiver operating characteristic（ROC）curves was constructed.Results In the urosepsis group,the serum concentration of PCT increased significantly（P0.01）;the levels of WBC and CRP slightly increased,but the difference was no statisticaly significance（P0.05）.Analysis of ROC curve displayed that area under the curve（AUC）of PCT was 0.981,which was higher than WBC and CRP（0.611 and0.661,respectively）.At the optimal operating point（3.42μg/L）,the sensitivity and specificity of PCT diagnosing urosepsis were 86.1% and91.3%,which were better than WBC and CRP.Conclusion Serum PCT is a reliable routine monitoring indicators for the early diagnosis of urosepsis with high sensitivity and specificity.