血清PCT联合痰培养对呼吸系统感染的诊断效果研究

Effect of serum PCT combined with sputum culture on diagnosis of respiratory system infection

目的探索血清降钙素原(PCT)联合痰培养对患者呼吸系统感染的诊断效果。方法选取2017年6月-2018年6月于医院接受治疗的384例呼吸系统感染患者为研究对象,采集患者静脉血进行PCT检测,留取痰标本进行病原菌培养与鉴定,分析痰培养阳性和阴性患者血清PCT水平的差异,分析检出病原菌的分布特点。结果 384例呼吸系统感染患者中188例上呼吸道感染,占48.96%,196例下呼吸道感染,占51.04%;上呼吸道感染患者PCT水平为(0.17±0.04)μg/L,下呼吸道感染患者PCT水平(0.16±0.03)μg/L,比较差异无统计学意义;384例呼吸系统感染患者PCT阳性257例占66.93%,痰培养阳性140例占36.46%,PCT阳性率高于痰培养阳性率(χ~2=5.024,P=0.025);痰培养阳性患者PCT水平高于阴性患者(P<0.05);痰培养共检出154株病原菌,革兰阴性菌105株,占68.18%,以铜绿假单胞菌、肺炎克雷伯菌为主;革兰阳性菌46株,占29.87%,以屎肠球菌、溶血性葡萄球菌为主;真菌3株,占1.95%,以白假丝酵母为主。结论不同部位呼吸系统感染患者血清PCT水平均较高,血清PCT与痰培养联合检测较单一检测具有更广的呼吸系统感染疾病检测范围,对早期判断呼吸系统感染患者具有重要作用。

OBJECTIVE To explore the effect of serum procalcitonin(PCT)combined with sputum culture on diagnosis of respiratory system infection.METHODS A total of 384 patients with respiratory system infection who were treated in the hospital from Jun 2017 to Jun 2018 were recruited as the study objects,the venous blood samples were collected from the patients for PCT test,the sputum specimens were cultured for pathogens,the isolated pathogens were identified,the serum PCT level was compared between the sputum culture-positive patients and the sputum culture-negative patients,and the distribution of the isolated pathogens was observed.RESULTS Of the 384 patients with respiratory system infection,188(48.96%)had upper respiratory tract infection,and 196(51.04%)had lower respiratory tract infection.The PCT level of the patients with upper respiratory tract infection was(0.17±0.04)μg/L,the patients with lower respiratory tract infection(0.16±0.03)μg/L,and there was no significant difference.Among the 384 patients with respiratory system infection,257(66.93%)were tested positive for PCT,140(36.46%)were positive for sputum culture,and the positive rate of the PCT was significantly higher than that of the sputum culture(χ~2=5.024,P=0.025).The PCT level of the sputum culture-positive patients was significantly higher than that of the sputum culture-negative patients(P<0.05).Totally 154 strains of pathogens were isolated from the sputum specimens,105(68.18%)of which were gram-negative bacteria,46(29.87%)were gram-positive bacteria,and 3(1.95%)were fungi;Pseudomonas aeruginosa and Klebsiella pneumoniae were the predominant species of the gram-negative bacteria;Enterococcus faecium and Staphylococcus haemolyticus were dominant among the gram-positive bacteria;Candida albicans was the predominant species of fungi.CONCLUSION The serum PCT level is high among the patients with respiratory system infection,the serum PCT combined with sputum culture may have wider range of detection of respiratory infectious diseases than the single detection,and it plays a significant role in early prediction of respiratory system infection.