血清降钙素原联合血培养对ICU患者菌血症的早期诊断价值  

The value of procalcitonin and blood culture in early diagnosis of sepsis in ICU patients

作　　者：童海明[1,2] 

机构地区：[1]绍兴市人民医院 [2]浙江大学绍兴医院临床检验中心,浙江绍兴312000

出　　处：《中国微生态学杂志》2013年第3期321-322,共2页Chinese Journal of Microecology

摘　　要：目的评价血清降钙素原(PCT)对ICU重症患者菌血症早期诊断的临床应用价值。方法用全自动快速定量法和免疫浊度法分别测定30例ICU重症菌血症患者的血清PCT和CRP浓度,并与血培养结果进行比较。结果菌血症组血培养、PCT及PCT+血培养的阳性率高于非菌血症组(P<0.01),而CRP则在两组之间差异无统计学意义(P>0.05)。PCT联合血培养检测对菌血症诊断的灵敏度、特异性、阳性预测值、阴性预测值分别为96.7%、93.3%、90.0%和93.3%,均高于血培养、CRP及PCT。在研究的30例菌血症患者中,血培养出23株病原菌,主要包括表皮葡萄球菌和大肠埃希菌。结论 PCT和血培养联合检测对ICU患者菌血症的早期诊断有较高价值。Objective To evaluate the clinical application value of procalcitonin （PCT） as a diagnostic marker of septicemia in ICU patients. Methods The levels of PCT and CRP of 30 septicemia patients and 30 non-septicemia patients were obtained by immuno- chromatography. The clinical data and correlative experimental results were collected and compared to the blood culture results. Results The positive rates of blood culture, PCT and PCT ＋ blood culture results in septicemia patients were higher than those in non-septicemia patients （ P 〈 0.01 ）, while there was no significant difference between the CRP of the two groups （ P 〉 0.05 ）. The sensitivity, specifici- ty, positive predictive value, and negative predictive values of the PCT ＋ blood culture results were 96.7% , 93.3% , 90% and 93.3% , respectively. All of them were higher than the results of the other three diagnosing tests. Among the 30 septicemia patients in ICU, there were 23 strains of bacteria isolated by the blood culture, which mainly included Staphylococcus epidermidis and Escherichia coll. Conclusion Determination of PCT and blood culture is valuable for the diagnosis of sepsis in ICU patients.

关 键 词：降钙素原 C反应蛋白 菌血症 

分 类 号：R378[医药卫生—病原生物学]