降钙素原检测联合血培养阳性时间评分用于严重败血症患者的预后判断  

Procalcitonin test combined with blood culture positivity scores in the prognosis for patients with severe septicemia

作　　者：叶晓涛 马焕丽[2] 陈日炳[3] 张旭[2] 

机构地区：[1]深圳市龙岗区坪地人民医院检验科,广东深圳518117 [2]深圳市龙岗中心医院检验科,广东深圳518117 [3]深圳市龙岗区人民医院检验科,广东深圳518117

出　　处：《国际检验医学杂志》2013年第15期1932-1934,共3页International Journal of Laboratory Medicine

基　　金：广东省深圳市科技计划项目(201203318);深圳市龙岗区科技计划医疗卫生资助项目(ys2012198)

摘　　要：目的评估降钙素原联合血培养阳性时间评分(PCTTs)对严重败血症患者早期预后判断的价值。方法纳入研究的为45例严重败血症患者,根据其临床结局分为:死亡组(24例)和生存组(21例)。分析并比较研究对象血浆降钙素原(PCT)水平、血培养阳性时间(TTP)和PCTTs,比较三者的受试者工作特征曲线(ROC)的特性。结果血浆PCT水平、TTP、PCTTs平均值,死亡组分别为12.41ng/mL、8.81h、8.42分,生存组分别为4.83ng/mL、12.13h、5.17分,两组间这三项参数的差异均有统计学意义(P<0.05)。血浆PCT水平、TTP和PCTTs用于预后判断的ROC曲线下面积(AUC)分别是0.777、0.725和0.803,对应最优截断点分别为5.345ng/mL、7.4h和4.5分,灵敏度分别为70.8%、50.0%和91.7%,特异度分别为71.4%、90.5%和57.1%。结论 PCTTs预测严重败血症患者死亡危险性有较好的准确性和灵敏度,血浆PCT水平检测联合TTP评估严重败血症患者预后有更好的临床应用价值。Objective To evaluate procalcitonin test combined with time to blood culture positivity（PCTTs） in the prognosis for patients with severe septicemia. Methods 45 patients with severe septicemia were enrolled in the study,which were divided into 2 groups,survival group（n= 24） and non-survival group（n= 21）, according to the clinical ends. Procalcitonin（PCT）, time to blood culture positivity （TTP） and PCTTs of the patients enrolled were analyzed,and the characteristics of the receiver operating characteristic curve（ROC） were compared between the 3 indicators. Results The mean values of PCT.TTP and PCTTs were compared between non-survival group and the survival group. Survival group： 12.41 ng/mL, 8. 81 h, 8. 42 score, respectively; non-survival group：4.83 ng/mL, 12. 13 h, 5. 17 score, respectively. PCT, TTP and PCTTs were significantly different between non-survival group and the survival group（P〈0.05）. The area under ROC curve（AUC） of the measurement PCT, TTP and PCTTs between non-survival group and the survival group were 0. 777,0. 725 and 0. 803,respectively;the optimal cutoff values were 5. 345 ng/mL, 7.4 h and 4.5 score;the sensitivity were 70.8% ,50.0% and 91.7%. The specificity were 71.4% ,90.5% and 57.1% ,respectively. Conclusion The PCTTs in the prognosis of mortality for the patients with severe septicemia has better accuracy and sensitivity. Combined measurement of plasma PCT and TTP could provide better clinical value in prognosis for the patients with severe septicemia.

关 键 词：降钙素原 败血症 血培养阳性时间 ROC曲线 

分 类 号：R446.5[医药卫生—诊断学]