早期血清降鈣素原與細菌性血流感染病原菌相關(guān)性研究
發(fā)布時間：2019-04-19 07:14
【摘要】：目的:探討早期血清降鈣素原(PCT)水平與細菌性血流感染患者病原菌種類之間的相關(guān)性;同時,試圖找到適宜的PCT臨界值,為細菌性血流感染起始抗感染經(jīng)驗治療方案的制定提供依據(jù),減少不必要的廣譜、超強、聯(lián)合用藥。方法:抽取某院2014年5月-2016年3月203例懷疑細菌性血流感染且在血培養(yǎng)前后12 h行血清降鈣素原(PCT)檢查的患者,按照革蘭陽性菌和革蘭陰性菌分組記錄患者血清降鈣素原(PCT),比較2組PCT水平的差異,用受試工作者曲線(ROC曲線)分析PCT在鑒別革蘭陽性菌和革蘭陰性菌血流感染的作用。結(jié)果:革蘭陰性菌血流感染與革蘭陽性菌血流感染早期PCT水平存在顯著性差異(P0.05),且革蘭陰性菌血流感染早期PCT明顯高于陽性菌,中位數(shù)分別為3.92 ng·mL-1和0.62 ng·mL-1;2組患者受試工作者曲線(ROC曲線)顯示PCT作為鑒別革蘭陰性菌和革蘭陽性菌血流感染有一定的意義(AUC為0.70,P0.05);以初次血清PCT1.81 ng·mL-1作為臨界值時,對革蘭陰性菌所致血流感染陽性預(yù)測值敏感性為62.3%,特異性為71.4%。結(jié)論:革蘭陰性菌血流感染患者早期血清降鈣素原(PCT)高于革蘭陽性菌;PCT對革蘭陰性菌和革蘭陽性菌所致細菌性血流感染有一定的鑒別作用;在PCT高于1.81 ng·mL-1時,細菌性血流感染革蘭陰性菌可能性較革蘭陽性菌大;可結(jié)合初次PCT結(jié)果做出病原體的初步判斷,為選擇適宜的起始抗感染治療方案提供幫助。
[Abstract]:Objective: to investigate the correlation between serum procalcitonin (PCT) level and pathogenic bacteria in patients with bacterial blood flow infection. At the same time, we tried to find a suitable critical value of PCT to provide the basis for the establishment of the initial anti-infection experience treatment scheme for bacterial blood flow infection, and to reduce unnecessary broad-spectrum, super-strong, combined use of drugs. Methods: from May 2014 to March 2016, 203 patients who were suspected of bacterial blood flow infection and underwent serum procalcitonin (PCT) examination 12 hours before and after blood culture were selected. The differences of serum procalcitonin (PCT), levels between the two groups were recorded according to gram-positive bacteria and gram-negative bacteria groups. The ROC curve was used to analyze the role of PCT in the identification of Gram-positive bacteria and Gram-negative bacteria blood flow infection. Results: there was a significant difference in PCT level between Gram-negative bacteria and Gram-positive bacteria in the early stage of blood flow infection (P0.05), and the PCT level of Gram-negative bacteria in the early stage of blood flow infection was significantly higher than that of the positive bacteria. The median values were 3.92 ng 路mL-1 and 0.62 ng 路mL-1, respectively. The workers' curve (ROC curve) showed that PCT could be used to distinguish Gram-negative bacteria from Gram-positive bacteria (AUC = 0.70, P0.05). When the initial serum PCT1.81 ng 路mL-1 was used as the critical value, the sensitivity and specificity of the positive predictive value for Gram-negative bacteria-induced blood flow infection were 62.3% and 71.4%, respectively. Conclusion: the serum procalcitonin (PCT) in the patients with Gram-negative bacterial blood flow infection is higher than that in the Gram-positive bacteria at the early stage, and PCT can differentiate the bacterial blood flow infection caused by Gram-negative bacteria and Gram-positive bacteria to a certain extent. When PCT was higher than 1.81 ng 路mL-1, Gram-negative bacteria was more likely to be infected by bacterial blood flow than Gram-positive bacteria, and the preliminary diagnosis of pathogens could be made according to the results of primary PCT, which would be helpful to select the appropriate initial anti-infection treatment scheme.
【作者單位】： 許昌市中心醫(yī)院藥學(xué)部;
【分類號】：R515
[Abstract]:Objective: to investigate the correlation between serum procalcitonin (PCT) level and pathogenic bacteria in patients with bacterial blood flow infection. At the same time, we tried to find a suitable critical value of PCT to provide the basis for the establishment of the initial anti-infection experience treatment scheme for bacterial blood flow infection, and to reduce unnecessary broad-spectrum, super-strong, combined use of drugs. Methods: from May 2014 to March 2016, 203 patients who were suspected of bacterial blood flow infection and underwent serum procalcitonin (PCT) examination 12 hours before and after blood culture were selected. The differences of serum procalcitonin (PCT), levels between the two groups were recorded according to gram-positive bacteria and gram-negative bacteria groups. The ROC curve was used to analyze the role of PCT in the identification of Gram-positive bacteria and Gram-negative bacteria blood flow infection. Results: there was a significant difference in PCT level between Gram-negative bacteria and Gram-positive bacteria in the early stage of blood flow infection (P0.05), and the PCT level of Gram-negative bacteria in the early stage of blood flow infection was significantly higher than that of the positive bacteria. The median values were 3.92 ng 路mL-1 and 0.62 ng 路mL-1, respectively. The workers' curve (ROC curve) showed that PCT could be used to distinguish Gram-negative bacteria from Gram-positive bacteria (AUC = 0.70, P0.05). When the initial serum PCT1.81 ng 路mL-1 was used as the critical value, the sensitivity and specificity of the positive predictive value for Gram-negative bacteria-induced blood flow infection were 62.3% and 71.4%, respectively. Conclusion: the serum procalcitonin (PCT) in the patients with Gram-negative bacterial blood flow infection is higher than that in the Gram-positive bacteria at the early stage, and PCT can differentiate the bacterial blood flow infection caused by Gram-negative bacteria and Gram-positive bacteria to a certain extent. When PCT was higher than 1.81 ng 路mL-1, Gram-negative bacteria was more likely to be infected by bacterial blood flow than Gram-positive bacteria, and the preliminary diagnosis of pathogens could be made according to the results of primary PCT, which would be helpful to select the appropriate initial anti-infection treatment scheme.
【作者單位】： 許昌市中心醫(yī)院藥學(xué)部;
【分類號】：R515
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