本文關(guān)鍵詞： 血流感染 降鈣素原 血培養(yǎng) ROC曲線分析 兒童　出處：《山東醫(yī)藥》2017年04期 　論文類型：期刊論文

【摘要】：目的探討血清降鈣素原(PCT)診斷兒童血流感染的價值。方法回顧性分析323例血培養(yǎng)陽性的血流感染患兒及120例血培養(yǎng)陰性患兒(血培養(yǎng)陰性組)的臨床資料。觀察血培養(yǎng)及血清PCT檢測結(jié)果,通過受試者工作特征(ROC)曲線評價PCT對血流感染的診斷價值,并計算最佳臨界值。結(jié)果 323例血培養(yǎng)陽性患兒分離出G-菌149株(GN組),G+菌153株(GP組),真菌21株(真菌組);血清PCT水平由高到低依次為不動桿菌屬、腸桿菌屬、大腸埃希菌感染。GN組、GP組、真菌組與血培養(yǎng)陰性組PCT水平分別為5.080(0.725~35.085)、0.270(0.120~0.700)、0.350(0.330~2.090)、0.245(0.090~0.560),GN組與GP組、真菌組、血培養(yǎng)陰性組比較差異均有統(tǒng)計學(xué)意義(P均0.01)。GN組和GP組不同PCT水平(0.5、0.2~2、2~10、10~50、50 ng/m L)G-菌感染率、G+菌感染率比較差異均有統(tǒng)計學(xué)意義(χ~2分別為29.538、22.365,P均0.01),且GN組高于GP組(χ~2=26.663,P0.01);真菌組不同PCT水平血流感染率比較差異無統(tǒng)計學(xué)意義(χ~2=0.850,P0.05)。PCT鑒別G-菌血流感染的ROC曲線下面積(AUC)為0.810,GP組為0.624;以1.03 ng/m L為最佳臨界值,PCT診斷G-血流感染的靈敏性為60.7%,特異性為78.6%,陽性預(yù)測值為89.7%,陰性預(yù)測值為39.3%,約登指數(shù)為39.3%。結(jié)論血清PCT水平對兒童革蘭陰性菌血流感染的診斷價值較高,1.03 ng/m L為其診斷的最佳臨界值。
[Abstract]:Objective to evaluate the value of serum procalcitonin (PCT) in the diagnosis of blood flow infection in children. Methods 323 children with positive blood culture and 120 children with negative blood culture were analyzed retrospectively. To observe the results of blood culture and serum PCT detection. The diagnostic value of PCT for blood stream infection was evaluated by the operating characteristics of the subjects. Results 149 strains of GN and 21 strains of fungi (fungi group) were isolated from patients with GN group, 153 strains of GN group and 21 strains of fungi (fungi group). The serum levels of PCT from high to low were Acinetobacter, Enterobacter, Escherichia coli infection and GP group. The levels of PCT in fungi group and blood culture negative group were 5.080, 0.725, 35.085, 0.270, 0.120 and 0.700, respectively. The GN group, GP group and fungus group were 0.350, 0.330, 2.090, 0.245, 0.090, 0.560, respectively. The difference of blood culture negative group was statistically significant (P < 0.01). GN group and GP group had different PCT levels of 0.5 ~ 0.2U ~ (2) ~ (2) ~ (10) ~ (10) ~ (10) ~ (50). There were statistically significant differences in the infection rates of 50 ng/m G- bacteria and G bacteria (蠂 ~ 2 = 29.538 ~ 22.365, P = 0.01). And the GN group was higher than GP group (蠂 2 + 26.663 P 0.01). There was no significant difference in blood flow infection rate between different PCT levels in fungal group (蠂 2 + 0.850). The area under ROC curve of P0.05. PCT for differentiating G- bacteria blood stream infection was 0. 810% GP group was 0. 624; Using 1.03 ng/m L as the best critical value, the sensitivity, specificity and positive predictive value were 60.7 and 78.6, respectively. Negative predictive value was 39.3 and Yorden index was 39.3. Conclusion Serum PCT level is of high diagnostic value in children with Gram-negative bacterial blood flow infection. 1.03 ng/m L was the best critical value for diagnosis.
【作者單位】： 首都醫(yī)科大學(xué)附屬北京兒童醫(yī)院;
【分類號】：R725.1
【正文快照】： 菌血癥和敗血癥是由細(xì)菌、真菌等病原微生物入侵血流所致的全身性炎癥反應(yīng)綜合征,統(tǒng)稱為血流感染。血流感染病死率高,患者往往發(fā)生多個器官的急性轉(zhuǎn)移性感染,因此早期診斷和治療至關(guān)重要[1]。血培養(yǎng)是實(shí)驗(yàn)室診斷血流感染的“金標(biāo)準(zhǔn)”,但培養(yǎng)時間長,陽性率低。近年來,血清降鈣

【相似文獻(xiàn)】

相關(guān)期刊論文 前10條

1 ;如何判斷導(dǎo)管內(nèi)相關(guān)性血流感染?[J];現(xiàn)代醫(yī)院;2009年04期

2 Michael Towns;;如何利用“血培養(yǎng)”高效地診治血流感染患者[J];中華醫(yī)院感染學(xué)雜志;2009年23期

3 李興武;;80歲以上老年患者的血流感染[J];國外醫(yī)學(xué)(老年醫(yī)學(xué)分冊);1994年06期

4 戚麗敏;崔屹;劉根焰;;產(chǎn)單核細(xì)胞李斯特菌血流感染1例報道[J];微生物與感染;2009年04期

5 張麗麗;劉梅;陳明;;血流感染研究進(jìn)展[J];醫(yī)學(xué)綜述;2010年04期

6 張偉三;張?zhí)N;;胸腺肽α1治療老年血流感染85例[J];中國老年學(xué)雜志;2010年06期

7 馬全玲;魏殿軍;;血流感染的危險因素及相關(guān)預(yù)防措施[J];醫(yī)學(xué)綜述;2010年13期

8 石娜;徐衛(wèi);章虹霞;舒雪芹;溫鴻;陳永平;;老年患者醫(yī)院血流感染危險因素的病例對照研究[J];中華醫(yī)院感染學(xué)雜志;2011年03期

9 張艷;華川;;血流感染診斷的研究進(jìn)展[J];國際檢驗(yàn)醫(yī)學(xué)雜志;2011年14期

10 梁s，

本文編號：1464944