血清降钙素原检测在血流感染治疗中的临床价值

Clinical Value of Serum Procalcitonin Detection in the Treatment of Bloodstream Infections

目的研究血清降钙素原检测在血流感染治疗中的临床价值。方法该次研究的对象是该院在2018年1月-2019年7月期间收治的500例血流感染患者,对不同病原菌感染患者的血清降钙素原水平、合并相关疾病对血清降钙素原水平的影响及不同血清降钙素原水平的灵敏度和特异性进行分析评价。结果按照不同病原菌感染情况主要将患者分成3组,分别为G+菌感染组、G-菌感染组、真菌感染组,G+菌感染组总例数为213例,血清降钙素原水平阳性数量为103例,血清降钙素原水平中位数为0.50 (0.19,2.88)ng/mL,G-菌感染组总人数为221例,血清降钙素原水平阳性数量为165例,血清降钙素原水平中位数为3.72(0.87,18.77)ng/mL,真菌感染组总人数为66例,血清降钙素原水平阳性数量为53例,血清降钙素原水平中位数为0.95(0.45,4.88)ng/mL,肾功能不全、自身免疫疾病、合并肺外感染、外伤及手术、胰腺炎、合并肺部感染、血液系统疾病、肿瘤等疾病对血清降钙素原水平的影响中可以发现,肾功能不全对相关水平的影响最大,自身免疫疾病对相关水平的影响比较小。血清降钙素原水平越低,灵敏度越高,特异性越低。结论血清降钙素原水平检测在血流感染治疗中的临床价值显著,能够随着患者的疾病呈现出不同的阳性率和变化。

Objective To study the clinical value of serum procalcitonin detection in the treatment of bloodstream infections. Methods The subjects of this study were 500 bloodstream infected patients admitted to the hospital from January 2018 to July 2019. The serum levels of procalcitonin in patients infected with different pathogens and the associated diseases effects of protonin levels and the sensitivity and specificity of different serum procalcitonin levels were analyzed and evaluated. Results Patients were divided into three groups according to the infection of different pathogens: G + bacteria infection group, G-bacteria infection group, and fungal infection group. The total number of G+ bacteria infection group was 213, and the positive number of serum procalcitonin levels was 103 case, the median serum procalcitonin level was 0.50(0.19, 2.88)ng/mL, the total number of case in the G-bacteria infection group was221, and the number of positive serum calcitonin levels was 165. The median number was 3.72(0.87, 18.77)ng/mL, the total number of case in the fungal infection group was 66, the number of positive serum procalcitonin levels was 53, the median serum procalcitonin level was 0.95(0.45, 4.88)ng/mL, and renal function Insufficiency, autoimmune diseases,combined with extrapulmonary infections, trauma and surgery, pancreatitis, combined lung infections, hematological diseases, tumors and other diseases can affect the level of serum procalcitonin, and renal insufficiency can affect the related levels. The impact is greatest, and the impact of autoimmune diseases on related levels is relatively small. The lower the serum procalcitonin level, the higher the sensitivity and the lower the specificity. Conclusion The detection of serum procalcitonin level has significant clinical value in the treatment of bloodstream infections, and can show different positive rates and changes with patients’ disease.