降钙素原检测鉴别细菌性肺炎患者革兰阳性菌与阴性菌感染的研究  

Research on procalcitonin level detection differentiating Gram- positive bacteria and Gram- negative bacteria infection in pneumonia patients

作　　者：梁军兵[1] 潘君素 赖卫强[1] 李婉红[1] 

机构地区：[1]台州市中心医院检验科,浙江台州318000 [2]台州市立医院呼吸科,浙江台州318000

出　　处：《中国卫生检验杂志》2014年第21期3114-3115,3118,共3页Chinese Journal of Health Laboratory Technology

摘　　要：目的探讨降钙素原(PCT)水平变化对鉴别细菌性肺炎患者革兰阳性菌与阴性菌感染的临床意义,以期指导临床及时、合理地应用抗菌药物。方法采用酶联荧光法对117例细菌性肺炎患者(革兰阳性菌51例,革兰阴性菌66例)和正常对照组20例进行血清PCT定量检测。结果感染组PCT水平均高于正常对照组,阴性菌感染组高于阳性菌感染组,组间差异具有统计学意义(P<0.05)。鉴别革兰阳性菌与阴性菌感染的ROC曲线下面积为0.746,95%置信区间为0.646~0.846,如cut-off值为7.90 ng/ml,灵敏度为82.0%,特异性为73.8%。阴性菌、阳性菌感染组治疗前PCT水平均高于治疗后,差异具有统计学意义(P<0.05)。结论 PCT在一定程度上能够鉴别细菌性肺炎患者阳性菌与阴性菌感染,同时可作为疗效观察的敏感指标,对临床早期诊断和经验性用药具有一定的临床意义。Objective To explore the clinical significance of changes of procalcitonin（PCT） level for differentiating Gram -positive bacteria and Gram- negative bacteria infection in patients with bacterial pneumonia, so as to rationally guide the clinical use of antimicrobial drugs in time. Methods Serum PCT levels were measured in 117 patients with bacterial pneumonia （51 cases of Gram -positive bacteria, 66 cases of Gram - negative bacteria） and 20 cases of healthy people by enzyme - linked fluo- rescent assay. Results The levels of PCT in patients with bacterial pneumonia were all higher than that in the normal group, and levels of negative bacteria infection group was higher than that of positive bacteria infection group, the differences between groups had statistical significance（ P 〈 0.05 ）. Identify the gram -positive b^cteria and negative bacteria infection area under the ROC curve ：0.746. 95% confidence interval was 0.646 ~ 0.846. For e^ample with the cut - off value of 7.90 ng/ml, sensitivity of 82.0% and specificity of 73.8%, the ＂PCT level in infection group before treatment were higher than those after the treatment, the differences between groups with statistical significance （P 〈 0.05）. Conclusion PCT was able to identify pneumonia with gram - positive bacteria and gram - negative bacteria infection, also was able to assists the early diagnosis, to provide theoretical evidence for correct use of antibiotics.

关 键 词：肺炎 降钙素原 革兰阳性菌 革兰阴性菌 

分 类 号：R515[医药卫生—内科学]