血清降钙素原检测对慢性肾衰竭患者合并细菌感染的临床应用价值

The clinical application value of serum procalcitonin detection in chronic renal failure patients merger of bacterial infection

目的探讨慢性肾衰竭(CRF)患者血清降钙素原(PCT)水平,以及PCT检测对CRF合并细菌感染患者的临床应用价值。方法选择2014年3月至2015年12月我院肾病内科临床确诊的单纯CRF患者50例、并发细菌性肺炎CRF患者50例及同期健康者50例。采用化学发光免疫分析法(CLIA)测定血清PCT浓度。结果 CRF组、并发细菌性肺炎CRF组PCT水平均明显高于正常对照组,并发细菌性肺炎CRF组患者PCT水平显著高于CRF组(P<0.05)。血清PCT诊断CRF并发细菌性肺炎的敏感性、特异性、阳性预测值、阴性预测值和准确性分别为94%、90%、90.4%、93.75%和92%。结论 CRF患者PCT水平升高,PCT检测对CRF并发细菌感染有重要的辅助诊断价值,可以指导CRF并发细菌感染者合理使用抗生素,避免抗生素滥用。

Objective To determine the serum levels of procalcitonin （PCT） in chronic renal failure patients （CRF） and investigate the clinicaJ value of the detection in CRF patients merger of babterial infection. Methods We selected 50 patients diagnosed as simple CRF,50 CRF patients merger of bacterial pneumonia in our hospital between March 2014 and December 2015 ,and 50 healthy controls at the same period as well. The serum PCT levels of these subjects were determined by using a chemil say （CLIA）. Results The serum PCT levels in the simple CRF group and the CRF complicated with bacterial pneumonia group were significantly higher than that in the healthy control group, and the levels in the CRF complicated with bacterial pneumonia group was significantly higher than that in the simple CRF group （P 〈 0. 05 ）. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of serum PCT in diagnosis of CRF complicated with bacterial pneumonia were 94% ,90% ,90.4% ,93.75% and 92% ,respectively. Conclusion The levels of serum PCT are increased in CRF. The detection of serum PCT has an important auxiliary diagnostic value for .CRF complicated with bacterial infection. It can guide the rational use of antibiotics to avoid antibiotic abuse for these patients.