Objective To evaluate the clinical significance and choicing antibiotics of serum procalcitonin (PCT) in acute fe-ver.Methods To make a retrospective analysis of 170 cases of febriledisease from January 2013 to January 2014.According to clini-cal causes of fever, the cases were divided between infectious fever group and non -infected group.The infectious group was divided by bacterial(A group) and viral infectious(B) groups.The bacterial group(A group) was divided by bloodstream infectious (A1) and fo-cal infectious(A2) groups.Tests of blood routine and CRP and PCT before or used antibiotics were analyzed and compared between the different groups.Results The PCT serum concentration of bacterial infectious gloup was higher than the viral infectious group and non-infected group( P <0.01).There wasn't significant difference in the viral infectious group and non -infected group( P >0.05). In bacterial infectious gloup, the area under ROC of PCT was 0.950 and CRP was 0.943, if PCT≥ 0.25ng/ml was regard as the cut-ff value, the sensitivity was 91.6% and the specificity was 93.3% ; if PCT≥ 0.5ng/ml was regard as the cut-ff value, the sensitivity was 95.2% and the specificity was 77.6%.Conclusions PCT tests are helpful to identify bacterial infection in patients with infec -tious fever .The more serious the higher PCT level , the earlier using antibiotics ,it is the most in bloodstream infection.There is an important significance for choicing antibiotics by the guidance of PCT ≥ 0.25ng/ml.%目的：探讨检测血清降钙素原（Procalcitonin，PCT）对急性发热患者的病因诊断及抗生素选择的临床意义。方法回顾性分析本科自2013年1月至2014年1月以“发热”收入院治疗中的170例急性发热患者，根据临床特征将其分为感染性发热组及非感染性发热组，感染性发热组再分为细菌感染组（A 组）及病毒感染组（B 组），分析比较各组血常规（WBC）、C－反应蛋白（CRP）及 PCT 水平和抗生素治疗前后 PCT 数值变化。结果细菌感染组分别较病毒感染组及非感染性发热组PCT 数值显著性增高（ P ＜0．01）；病毒感染组与非感染性发热组差异无统计学意义（ P ＞0．05）。在细菌感染组曲线下面积PCT 最大（AUG 0．950），其次 CRP（AUG 0．943）；如将 PCT≥0．25ng／ml 作为细菌感染的界值，灵敏度为91．6％，特异度为93．3％；如将 PCT≥0．5ng／ml 作为细菌感染的界值，灵敏度为95．2％，特异度为77．6％。结论血清 PCT 检测可用于判断感染性发热是否为细菌性感染，PCT 值越高感染程度越重，血流感染最显著，越应及早使用抗生素。 PCT≥0．25ng／ml 水平可作为选择抗生素的参考依据。
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