革兰阳性与阴性菌感染血清降钙素原水平比较  

Serum procalcitonin levels in patients infected by either gram-positive or gram-negative bacteria

作　　者：顾敏[1] 包正军[1] 曾欣荣[1] 蒋最明 金今[1] 彭俊[1] 

机构地区：[1]株洲市一医院,湖南株洲412000

出　　处：《中国感染控制杂志》2011年第6期449-451,448,共4页Chinese Journal of Infection Control

摘　　要：目的探讨患者血清降钙素原(procalcitonin,PCT)水平对区分常见革兰阳性(G^+)菌和革兰阴性(G^-)菌所致感染的价值。方法通过对血、痰、尿等133份标本细菌培养及患者血清PCT水平测定,分析G^+菌及G^-菌感染后,患者体内PCT分布水平是否存在差异。结果当血液中能培养出细菌时,G^-菌感染组血清PCT水平[(38.45±60.30)ng/mL明显高于G^+菌感染组[(4.64±7.81)ng/mL],差异有统计学意义(P<0.001);根据受试者工作特征曲线(ROC),血清PCT界值设定为5.61 ng/mL时,其灵敏度为73.70%,特异性为81.80%。痰液及其他标本培养出细菌时,感染者血清PCT水平差异无统计学意义(P>(0.05)。血培养阳性组血清PCT水平明显高于其他组(P<0.001)。结论血清PCT水平测定有助于迅速区分G^+菌及G菌所致的血流感染,但对于肺部及其他局灶感染,其鉴别价值有待进一步研究。Objective To evaluate the value of serum procalcitonin （PCT） levels for differentiating gram-positive and gram-negative bacterial infection. Methods 133 samples of blood, sputum, urine, or the others were performed bacterial culture, and serum PCT levels we：re measured and analyzed to find whether there was difference in PCT levels between gram-positive and gram-negative bacteria infected patients. Results When bacteria were isolated from blood culture, serum PCT levels in patients with gram-nagetive bacterial infection were obviously higher than that of gram-positive group （[-38.45 ＋ 60. 30~）ng/mL vs [-4. 64 ＋ 7. 81~）ng/mL, P^0. 001） ~ According to receiver oper- ating characteristic curve, if 5.61 ng/mL was taken as critical value, PCT sensitivity in the diagnosis of infection was 73. 70%, and specificity was 81.80%. When sputum and the other samples were isolated bacteria, there was no statistical difference in patients＇ serum PCT levels （P^0. 05）. PCT level in positive blood culture group was significantly higher than those of the other groups （P〈0. 001）. Conclusion Serum PCT level is valuable to discriminate blood stream infection caused by gram-negative from gram-positive bacteria, but the value to discriminate lung and the other local infection need to be further studied.

关 键 词：革兰阳性菌 革兰阴性菌 降钙素原 血流感染 局灶感染 

分 类 号：R446[医药卫生—诊断学]