本文選題：PCT + 慢性腎病　； 參考：《中華醫(yī)院感染學(xué)雜志》2017年10期

【摘要】：目的探討血清降鈣素原(PCT)對慢性腎病患者細菌感染的診斷效果,為提升慢性腎病細菌感染患者的療效提供科學(xué)依據(jù)。方法選取醫(yī)院住院治療的慢性腎病患者2 104例,根據(jù)是否發(fā)生院內(nèi)細菌感染分為感染組116例和非感染組1988例,比較兩組患者的血清PCT含量,計算PCT對慢性腎病患者細菌感染的靈敏度和特異性,分析感染組患者的病原菌分布以及相關(guān)病原菌的耐藥性。結(jié)果兩組患者的血清PCT含量差異有統(tǒng)計學(xué)意義(P0.05),經(jīng)治療后,與感染組治療前相比,差異有統(tǒng)計學(xué)意義(P0.05);以PCT≥0.4ng/ml作為陽性標(biāo)準(zhǔn),靈敏度80.2%(93/116),特異性97.6%(1941/1988);陽性預(yù)測值66.4%(93/140),陰性預(yù)測值98.8%(1941/1964);116例感染患者共培養(yǎng)出132株病原菌,感染單一菌株患者100例,混合感染患者16例,革蘭陰性菌93株占70.5%,革蘭陽性菌39株占29.5%;感染組患者革蘭陰性菌中,銅綠假單胞菌對頭孢唑林、紅霉素、氧氟沙星、諾氟沙星、環(huán)丙沙星等耐藥率較高,85.0%,對亞胺培南和美羅培南敏感,耐藥率6.0%;大腸埃希菌對頭孢唑林、紅霉素、氧氟沙星、環(huán)丙沙星等耐藥率較高,70.0%,對阿米卡星、亞胺培南、美羅培南敏感,耐藥率13.0%;革蘭陽性菌中,金黃色葡萄球菌對青霉素、替卡西林、阿莫西林、頭孢曲松等耐藥率較高,80.0%,對芐卡西林、萬古霉素敏感,耐藥率為0;表皮葡萄球菌對青霉素、替卡西林、阿莫西林、頭孢曲松等耐藥率較高,75.0%,對萬古霉素敏感,耐藥率為0。結(jié)論血清PCT的檢測對于慢性腎病患者細菌感染早期的診斷指標(biāo)具有較高的靈敏性和特異性,具有一定的臨床診斷價值;慢性腎病患者感染以銅綠假單胞菌、大腸埃希菌為主,臨床應(yīng)根據(jù)藥敏結(jié)果合理使用抗菌藥物進行治療,以提升感染患者的治療效果和預(yù)后。
[Abstract]:Objective to investigate the diagnostic effect of serum procalcitonin (PCT) on bacterial infection in patients with chronic nephropathy, and to provide scientific basis for improving the efficacy of bacterial infection in patients with chronic nephropathy. Methods two hundred and four patients with chronic nephropathy treated in hospital were divided into two groups according to whether or not nosocomial bacterial infection occurred. The serum levels of PCT in the two groups were compared between the infected group (116 cases) and the non-infected group (1988 cases). The sensitivity and specificity of PCT to bacterial infection in patients with chronic nephropathy were calculated. Results there was a significant difference in serum PCT levels between the two groups (P 0.05). After treatment, the difference was statistically significant compared with that before treatment in the infection group, and the positive criteria were PCT 鈮，

本文編號：2018018