本文選題：降鈣素原 + 血流感染�。� 參考：《中華醫(yī)院感染學(xué)雜志》2017年02期

【摘要】：目的探討血清降鈣素原(PCT)水平對(duì)鑒別腫瘤患者細(xì)菌血流感染病原體的臨床應(yīng)用價(jià)值,為臨床應(yīng)用提供參考。方法收集2012年7月1日-2015年6月30日醫(yī)院214例血培養(yǎng)結(jié)果陽性,并檢測(cè)了血清PCT水平的腫瘤患者的臨床資料;比較PCT水平、白細(xì)胞計(jì)數(shù)(WBC)和體溫在革蘭陰性菌、革蘭陽性菌血流感染患者間的差異,同時(shí)根據(jù)受試者工作曲線(ROC)判斷PCT的診斷價(jià)值。結(jié)果革蘭陰性菌組和革蘭陽性菌組PCT水平中位數(shù)分別為15.12、0.42ng/ml,革蘭陰性菌組血清PCT明顯高于革蘭陽性菌組,組間比較差異有統(tǒng)計(jì)學(xué)意義(P0.01);兩組患者WBC計(jì)數(shù)、體溫差異無統(tǒng)計(jì)學(xué)意義;根據(jù)ROC曲線,當(dāng)界值設(shè)定為0.54ng/ml時(shí),血清PCT水平區(qū)分革蘭陰性菌與革蘭陽性菌所致血流感染的靈敏度為83.1%,特異度為79.5%。結(jié)論血清PCT水平對(duì)鑒別革蘭陰性菌與革蘭陽性菌引起的腫瘤患者的血流感染有一定的提示意義,可為臨床早期使用抗菌藥物提供參考。
[Abstract]:Objective to study the clinical application value of serum procalcitonin (PCT) level in differentiating bacterial blood stream infection pathogens in tumor patients. Methods from July 1, 2012 to June 30, 2015, 214 patients with positive blood culture results were collected, and the clinical data of tumor patients with serum PCT levels were detected, and the levels of PCT, white blood cell count (WBC) and body temperature were compared in Gram-negative bacteria. The difference between the patients with Gram-positive bacterial blood flow infection and the diagnostic value of PCT were evaluated according to the operating curve (ROC) of the subjects. Results the median levels of PCT in Gram-negative bacteria group and Gram-positive bacteria group were 15.12 ~ 0.42 ng / ml, respectively. The serum PCT level in Gram-negative bacteria group was significantly higher than that in Gram-positive bacteria group (P0.01), but there was no significant difference in WBC count and body temperature between the two groups. According to the ROC curve, when the threshold was set to 0.54ng/ml, the sensitivity and specificity of serum PCT to distinguish blood stream infection caused by Gram-negative bacteria and Gram-positive bacteria were 83.1 and 79.5 respectively. Conclusion the level of serum PCT may be helpful in differentiating the blood stream infection of tumor patients caused by Gram-negative bacteria and Gram-positive bacteria, and can provide a reference for early clinical use of antimicrobial agents.
【作者單位】： 天津醫(yī)科大學(xué)腫瘤醫(yī)院檢驗(yàn)科國(guó)家腫瘤臨床醫(yī)學(xué)研究中心天津市腫瘤防治重點(diǎn)實(shí)驗(yàn)室;
【基金】：國(guó)家自然科學(xué)基金(81402174)
【分類號(hào)】：R730.43

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