血清PCT/ALB对老年维持性血液透析患者细菌感染的诊断价值

Diagnostic value of serum PCT/ALB in bacterial infection in elderly patients with maintenance hemodialysis

目的检测血清降钙素原(PCT)、白蛋白(ALB)水平,探讨PCT/ALB对老年维持性血液透析(MHD)患者细菌感染的诊断价值。方法选取2022年1月-2024年1月在成都市第六人民医院进行MHD治疗的84例老年患者为研究对象,根据细菌培养结果将患者分为感染组(n=23)和未感染组(n=61)。采用化学发光方法检测PCT水平,使用溴甲酚绿法检测ALB水平,计算PCT/ALB。采用受试者工作特性(ROC)曲线分析PCT、ALB水平及PCT/ALB对患者合并细菌感染的诊断价值;采用多因素logistic回归分析老年MHD患者细菌感染的影响因素。结果感染组PCT、PCT/ALB分别为(21.76±1.47)ng/mL、(0.65±0.06),高于未感染组(18.32±1.39)ng/mL、(0.46±0.05),ALB(33.61±4.36)g/L低于未感染组(40.12±5.07)g/L,差异均有统计学意义(t=9.957、14.687、5.441,P均<0.001)。PCT、ALB及PCT/ALB诊断老年MHD患者细菌感染的曲线下面积(AUC)分别为0.791(95%CI:0.746~0.841)、0.814(95%CI:0.769~0.864)、0.926(95%CI:0.881~0.976)。感染组合并糖尿病人数比例、B型脑尿钠肽水平高于未感染组,差异均有统计学意义(χ^(2)/t=9.957、12.580,P均<0.01)。结论PCT/ALB在老年MHD细菌感染患者中呈高表达,可作为诊断老年MHD患者是否发生细菌感染的重要指标。

Objective To investigate the diagnostic value of serum procalcitonin(PCT)/albumin(ALB)in bacterial infection in elderly patients with maintenance hemodialysis(MHD).Methods A total of 84 elderly patients who received maintenance hemodialysis therapy in the Chengdu Sixth People's Hospital from January 2022 to January 2024 were selected as the subjects of this study.According to the results of bacterial culture,they were divided into infected group(n=23)and uninfected group(n=61).Fluorescence immunoassay was used to detect PCT,immunoturbidimetry was used to detect ALB,and PCT/ALB was calculated.Receiver operating characteristic(ROC)curve was used to analyze the diagnostic value of PCT,ALB and PCT/ALB for bacterial infection.The influencing factors of bacterial infection in elderly MHD patients were explored by multivariate logistic regression analysis.Results The PCT and PCT/ALB values in the infected group(21.76±1.47)ng/mL,(0.65±0.06)were higher than those in the uninfected group(18.32±1.39)ng/mL,(0.46±0.05).The ALB value(33.61±4.36)g/L was lower than that of uninfected group(40.12±5.07)g/L,and the differences were statistically significant(t=9.957,14.687,5.441;all P<0.001).The area under the curve(AUC)of PCT,ALB and PCT/ALB in the diagnosis of bacterial infection in elderly MHD patients were 0.791(95%CI:0.746-0.841),0.814(95%CI:0.769-0.864)and 0.926(95%CI:0.881-0.976),respectively.The proportion of patients with diabetes mellitus and the level of B⁃type cerebrourinary natriuretic peptide were significantly higher than those in the uninfected group(χ^(2)/t=9.957,12.580;all P<0.01).Conclusion PCT/ALB was highly expressed in elderly patients with bacterial infection of MHD,and could be used as an important indicator to diagnose bacterial infection in elderly patients with MHD.