ICU不同病原菌感染降钙素原变化规律曲线的差异性研究  

Difference in the curve of procalcitonin change in infections caused by different pathogens in ICU

作　　者：罗华[1] 蔡文训[1] 张卫星[1] 张声[1] 林影芯[1] 

机构地区：[1]北京大学深圳医院ICU,广东省深圳市518036

出　　处：《实用医学杂志》2013年第15期2474-2477,共4页The Journal of Practical Medicine

基　　金：2010年深圳市科技计划项目(编号:201003081)

摘　　要：目的:通过动态观察ICU感染者不同时点降钙素原(PCT)水平和变化规律,评价其鉴别不同病原菌感染的意义。方法:132例感染者在感染第1、3、5、7、14天检测PCT,以Microsoft Excel 2003分别描绘革兰阳性球菌、革兰阴性杆菌、真菌及复合感染者的PCT变化规律曲线图,以SPSS 13.0对比曲线参数的差异。结果:(1)3种病原菌的PCT曲线趋势相似,但PCT峰值、平均值和日变化幅度革兰阴性杆菌患者最高,革兰阳性球菌患者最低,真菌感染者介于两者间且接近革兰阳性球菌。(2)感染早期就可出现PCT日变化幅度的差别。(3)复合感染PCT分布整体高于单一感染但局部有重叠。结论:不同病原菌感染具有不同的PCT变化规律,其比PCT水平高低更能全面地反映感染;结合PCT规律曲线和日变化幅度可辅助鉴别单一病原菌感染。Objective To assess the significance of procalcitonin （PCT） in identifying infections caused by different pathogens by dynamic observation of PCT levels and changes in ICU patients with infections. Methods PCT levels were detected 132 patients on days 1, 3, 5, 7 and 14 after infection. The Microsoft Excel 2003 depicted the curve of changes in PCT for Gram-positive cocci, Gram-negative bacilli, fungi, and coinfection. And the SPSS 13.0 was used to analyze the differences in the curve parameters. Results The trend of the PCT curves for the three pathogens were similar. However, peak level, average values, and daily changes were mainly found in Gram-negative bacilli infections, followed by fungal infections and Gram-positive cocci infections. The difference of PCT daily changes was seen in the early stage of infection. PCT values as a whole in confection were greater than single infection but had partial overlap. Conclusions Infections with different pathogens have different regular patterns of PCT, which provides more comprehensive information on infections than the PCT levels. The trend of PCT curve combined with daily change level is helpful in early identification of infections with single pathogen

关 键 词：降钙素原 规律 感染 鉴别诊断 ICU 

分 类 号：R446.5[医药卫生—诊断学]