降钙素原提示血流感染病原体类型的研究

Effect of procalcitonin level for distinguishing gram-negative bacteria from gram-positive bacteria bloodstream infection

目的 分析血清降钙素原(PCT)水平能否提示血流感染病原体类型,为临床早期经验用药提供参考。方法选取2016年1月1日至2017年12月31日某院血培养阳性的细菌性血流感染患者98例,分为革兰阴性菌组与革兰阳性菌组,观察两组间的PCT水平有无统计学差异。结果 共分析了98例细菌性血流感染患者,其中革兰阴性菌组(n=51)的PCT中位数是20.65ng/ml,革兰阳性菌组(n=47)的PCT中位数是1.30ng/ml,两组差异显著,具有统计学意义(P=0.001);ROC曲线下面积为0.721,取PCT 6.10ng/ml作为阈值时,革兰阴性菌区别革兰阳性菌的敏感度为66.7%,特异性为72.3%。结论 PCT结果可以提示血流感染病原体类型,有助于细菌性血流感染患者在血培养结果出来前的经验用药。

Objective To investigate the effect of procalcitonin(PCT)level for distinguishing gram-negative bacteria from gram-positive bacteria bloodstream infection.Methods A total of 98 patients with bloodstream infection were analyzed,include gram-negative bacteria group and gram-positive bacteria group.The PCT levels in the two groups have been compared.Results A total of 98 patients with bloodstream infection were analyzed,include 51 gram-negative bacteria and 47 gram-positive bacteria bloodstream infection.The medians of PCT levels in gram-negative group and grampositive group were 20.65 ng/ml and 1.30 ng/ml respectively.The difference was significant(P=0.001).The area under ROC curve of PCT levels for distinguish gram-negative bacteria from gram-positive bacteria bloodstream infection was 0.721,the sensitivity and specificity were 66.7% and 72.3% respectively while PCT 6.10 ng/ml was chosen as the cut-off value.Conclusion PCT level may help to distinguish gram-negative bacteria from gram-positive bacteria bloodstream infection which was useful for clinical early medication in patients with bacterial bloodstream infection.