血清降钙素原定量与半定量检测在细菌感染诊断中的效能比较

Comparison of efficacies of quantitative and semi-quantitative detection of serum procalcitonin in diagnosis of bacterial infections

目的:比较血清降钙素原(PCT)定量与半定量检测在细菌感染诊断中的效能。方法:选取182例疑似细菌感染患者作为研究对象,用胶体金免疫结合半定量法、化学发光定量法对所有患者进行血清PCT水平检测,比较两种检测方法诊断细菌感染的特异度、灵敏度。结果:细菌培养结果显示:182例疑似患者中,细菌感染153例,非细菌感染29例;细菌感染的患者中有局部细菌感染64例,全身炎性反应综合征(SIRS)51例,脓毒血症38例;经受试者工作特征曲线分析得知,将PCT≥0.5 ng/mL当作阳性诊断界点,化学发光定量法检测的特异度为65.41%,灵敏度为95.52%,明显高于胶体金免疫结合半定量法检测的46.32%、85.42%;SIRS和脓毒血症患者PCT水平明显高于局部细菌感染患者和非细菌感染患者,且脓毒血症患者PCT水平明显高于SIRS患者,差异均有统计学意义(P<0.05);SIRS患者、脓毒血症患者PCT阳性率均高于局部细菌感染患者和非细菌感染患者,差异均有统计学意义(P<0.05);局部细菌感染患者和非细菌感染患者的血清PCT水平、PCT阳性率比较,脓毒血症患者和SIRS患者的PCT阳性率比较,差异均无统计学意义(P>0.05)。结论:血清PCT定量检测对细菌感染的诊断效能高于半定量检测的诊断效能,且检测血清PCT水平对诊断全身细菌感染的价值更高,可指导临床治疗。

Objective:To compare efficacies of quantitative and semi-quantitative detection of serum procalcitonin in diagnosis of bacterial infections.Methods:182 patients with suspected bacterial infection were selected as the research objects.The serum PCT levels were detected in all patients with colloidal gold immunobinding semi-quantitative method and chemiluminescence quantitative method.Then,the specificity and sensitivity in the diagnosis of bacterial infection were compared between the two detection methods.Results:The bacterial culture results showed that among the 182 suspected patients,153 were diagnosed as bacterial infections and 29 were non-bacterial infections;among the bacterial infections,there were 64 cases of local bacterial infections,51 cases of systemic inflammatory response syndromes(SIRS),and 38 cases of sepsis.According to the receiver operating curve(ROC)analysis,PCT≥0.5 ng/mL was the positive diagnostic cut-off point.The specificity and sensitivity of chemiluminescence quantitative detection were 65.41%and 95.52%,which were significantly higher than 46.32%and 85.42%of colloidal gold immunobinding semiquantitative method.The PCT levels of the patients with SIRS and sepsis were significantly higher than those of the patients with local bacterial infection and non-bacterial infection;the PCT levels of the patients with sepsis were significantly higher than those of the SIRS patients;and the differences were statistically significant(P<0.05).The positive rates of PCT in the patients with SIRS and sepsis were higher than those in the patients with local bacterial infection and non-bacterial infection,and the differences were statistically significant(P<0.05).However,there were no significant differences in the serum PCT level and PCT positive rate between the patients with local bacterial infection and those without bacterial infection,and the positive rate of PCT between the patients with sepsis and those with SIRS(P>0.05).Conclusions:The efficiency of serum PCT quantitative detection in the diagnosis of bacterial infection is higher than that of semi-quantitative detection.Moreover,the detection of serum PCT level is of higher value in the diagnosis of systemic bacterial infections and can be used to guide the clinical treatment.