血清降钙素原对血流感染患者病原菌的鉴别诊断价值

摘要

目的：研究血清降钙素原( PCT)在血流感染患者病原菌鉴定中的临床价值。方法采用回顾性分析的方法,对335例血培养阳性血流感染患者的血清PCT检测结果进行分析。结果335例血培养结果阳性的血流感染患者中,革兰阴性菌144例,占42．99%(144/335)；革兰阳性菌159例,占47．46%(159/335)；真菌32例,占9．55%(32/335)。不同菌株间PCT检测结果分别为6．52(0．98~35．3)ng/ml,1．83(0．49~8．6)ng/ml和2．08(0．45~13．1)ng/ml；经Mann-Whitney U检验,革兰阴性菌组与其他两组间差异均具有显著性,(U=356,U=581,P<0．05)。使用受试者工作曲线对PCT在革兰阴性菌鉴别中的检测效能进行分析,临界值为3．15 ng/ml 时, ROC 曲线下面积为0．77；此时鉴定革兰阴性菌的灵敏度为71．2%,特异度为69．1%,准确指数40．30%。结论定量检测PCT可作为鉴别血流感染患者革兰阴性菌和革兰阳性菌感染的辅助诊断手段。%Objective To investigate the clinical value of serum procalcitonin ( PCT) on bacterial strain i-dentification in blood stream infection patients. Methods The serum PCT of 335 cases of blood stream infection with positive blood culture results were analyzed. Results A total of 335 bacterial isolates were collected based on blood culture, including 144 gram negative bacterial strains (42. 99%), 159 gram negative bacterial strains (47. 46%) and 32 strains of fungi (9. 55%). The median of PCT level was higher in gram negative bacterial strains than others (6. 52 vs 1. 83 vs 2. 08 ng/ml, P<0. 05). Taking the cut-off point of 3. 15 ng/ml to identify gram-negative bacteria infection, the area under the ROC curve was 0. 77. The sensitivity and specificity were 71. 2% and 69. 1%, respec-tively. Conclusion Serum PCT can be used as a helpful tool on bacterial strain identification in blood stream infec-tion.