血清降钙素原在血液透析导管相关性感染诊断中的应用价值

Application value of serum procalcitonin in diagnosis of hemodialysis catheter-related infection

目的探讨血清降钙素原(PCT)在行血液透析置管引起的导管相关性感染诊断中的应用价值。方法采用免疫化学发光法检测导管相关性感染患者(75例)和非感染患者(400例)血清PCT和白细胞计数(WBC)水平,通过ROC曲线评价PCT和WBC指标对导管相关性感染的诊断价值。结果感染组患者血清PCT为(1.58±0.36)ng/ml,WBC水平为(7.53±0.67)×10~9/L,显著高于非感染组PCT为(0.11±0.08)ng/ml,WBC水平为(5.15±0.52)×10~9/L,差异具有统计学意义(P<0.05);ROC曲线分析显示,血清PCT和WBC的ROC曲线下面积(AUC)分别为0.845和0.512,并且PCT的AUC、诊断的敏感性(84.2%)及特异性(82.6%)均较WBC(敏感性:61.5%,特异性:30.7%)升高。结论血清PCT水平在血液透析导管相关性感染患者中明显升高,其对导管相关性感染的诊断具有较好的敏感性和特异性。

Objective To investigate application value of serum procalcitonin（PCT） in diagnosis of hemodialysis catheterization-induced catheter-related infection. Methods Immunochemistry luminescence method was applied to detect serum PCT and white blood cell count（WBC） levels in catheter-related infection patients（75 cases） and patients without infection（400 cases）. Diagnostic value by PCT and WBC for catheterrelated infection was evaluated by ROC curve. Results The infection group had serum PCT as（1.58±0.36） ng/ml and WBC as（7.53±0.67）×10~9/L, which were obviously higher than PCT as（0.11±0.08） ng/ml and WBC as（5.15±0.52）×10~9/L in the non-infection group, and their difference had statistical significance（P0.05）. ROC curve analysis showed area under curve（AUC） of ROC respectively as 0.845 and 0.512 in serum PCR and WBC. PCT had all higher AUC, sensitivity（84.2%） and specificity（82.6%） in diagnosis than WBC（sensitivity as 61.5%, specificity as 30.7%）. Conclusion High level of serum PCT is shown in patients with hemodialysis catheterrelated infection, and it provides excellent sensitivity and specificity in diagnosis of catheter-related infection.