本文選題：降鈣素原 + 血培養(yǎng)陽性��； 參考：《中華醫(yī)院感染學雜志》2016年16期

【摘要】：目的探討血清降鈣素原(PCT)預測血培養(yǎng)陽性的臨床應用價值。方法采用回顧性分析研究,以2012年12月-2014年12月同時進行PCT和血培養(yǎng)檢測1 164例患者為研究對象,根據(jù)血培養(yǎng)結(jié)果分為陽性組和陰性組,比較兩組間PCT、C-反應蛋白(CRP)水平等實驗室指標的差異。結(jié)果血培養(yǎng)陽性組PCT、CRP明顯高于血培養(yǎng)陰性組,差異有統(tǒng)計學意義(P0.001);單因素logistics回歸分析顯示,PCT、CRP及體溫均為菌血癥預測因子,差異有統(tǒng)計學意義(P0.001),多因素logistics回歸分析顯示,校正年齡、抗菌藥物預處理因素后,年齡、PCT、CRP是預測血培養(yǎng)陽性的獨立預測因子;血清PCT預測血培養(yǎng)陽性ROC曲線下面積為0.800,當截斷點為PCT0.05ng/ml時,PCT預測血培養(yǎng)陽性的敏感性高達96%,與其他臨床實驗室指標相比,PCT預測血培養(yǎng)陽性診斷價值最高;在PCT0.05ng/ml時,菌血癥發(fā)生風險低,而PCT0.5ng/ml時,菌血癥發(fā)生風險高,有利于早期診斷和病情檢查,合理使用抗菌藥物。結(jié)論 PCT預測血培養(yǎng)陽性是非常有意義的,比CRP、WBC計數(shù)和其他臨床實驗室指標均要好,而且血清PCT檢測能夠減少患者的血培養(yǎng)數(shù)量及醫(yī)療成本,實施更合理的衛(wèi)生保健資源分配。
[Abstract]:Objective to investigate the clinical application value of serum calcitonin (PCT) in predicting the positive blood culture. Methods a retrospective analysis was carried out in 1164 patients with PCT and blood culture in December December 2012 -2014. The results were divided into positive and negative groups according to the result of blood culture, and compared the level of PCT, C- reactive protein (CRP) among the two groups. Results the difference of laboratory indexes. Results the positive blood culture group PCT, CRP was significantly higher than the negative blood culture group, the difference was statistically significant (P0.001). The single factor logistics regression analysis showed that PCT, CRP and body temperature were all predictive factors of bacteremia, the difference was statistically significant (P0.001). The multiple factor logistics regression analysis showed that the correction age, the antibacterials were pretreated. After the treatment, age, PCT, and CRP were independent predictors of positive blood culture, and serum PCT predicted that the area under the positive ROC curve of blood culture was 0.800. When the truncated point was PCT0.05ng/ml, the sensitivity of PCT to predict the positive blood culture was up to 96%. Compared with other clinical laboratory indicators, PCT predicted the positive diagnostic value of blood culture; in PCT0.0, the value of the positive blood culture was the highest; in PCT0.0 At the time of 5ng/ml, the risk of bacteremia is low and the risk of bacteremia is high at PCT0.5ng/ml. It is beneficial to early diagnosis and condition examination and rational use of antibiotics. Conclusion PCT is very meaningful to predict positive blood culture. It is better than CRP, WBC count and other clinical laboratory indexes, and serum PCT detection can reduce the blood culture of patients. To provide more reasonable allocation of health care resources by maintaining quantity and medical costs.
【作者單位】： 浙江省臺州醫(yī)院檢驗科;
【基金】：浙江省科技廳基金資助項目(2016C33SA800035)
【分類號】：R446.1

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