透析感染患者血浆降钙素原和C-反应蛋白的比较研究  

Comparative study of plasma levels of calcitonin and C-reactive protein in patients with dialysis and infections

作　　者：高慧[1] 吕利明[2] 张晓华[1] 郭颖超[1] 房婧[1] 

机构地区：[1]山东中医药大学第二附属医院血液透析科,山东济南250001 [2]山东中医药大学护理学院,山东济南250355

出　　处：《中华医院感染学杂志》2016年第19期4404-4406,共3页Chinese Journal of Nosocomiology

基　　金：山东省中医药科技发展计划基金资助项目(2011-107)

摘　　要：目的探究透析感染患者血浆降钙素原（PCT）和C-反应蛋白（CRP）水平,分析其临床诊断的意义。方法随机选择2012年9月-2014年11月医院87例维持性血液以及腹膜透析患者作为研究对象,将其中39例发生感染的患者作为观察组,48例未感染患者作为对照组,比较两组患者PCT及CRP的浓度,分析PCT及CRP等指标的敏感性以及特异性,研究其临床诊断价值。结果观察组患者透析前7天PCT水平及CRP水平与对照组比较差异无统计学意义,而观察组患者透析前4天、前1天PCT水平及CRP水平明显高于对照组,两组比较差异有统计学意义（P〈0.05）;对观察组患者进行检查后,PCT及CRP检测患者阳性率分别为94.9%和100.0%;对两组患者进行降钙素原检测显示,观察组患者降钙素原浓度〈1.5ng/mL 2例,1.5~10ng/mL31例,〉10ng/mL6例,对照组患者降钙素原浓度为〈1.5ng/mL 48例,无降钙素原浓度为1.5~10及〉10ng/mL患者;观察组患者标本培养出病原菌37株,其中革兰阳性菌21株,革兰阴性菌13株,真菌3株,分别占56.9%、35.1%和8.1%。结论 PCT及CRP水平对于诊断患者感染有着重要意义,应作为透析患者合并感染的重要参考依据。OBJECTIVE To explore the levels and clinical significance of plasma levels of calcitonin（PCT）and Creactive protein（CRP）in patients with dialysis complicated with infections.METHODS A total of 87 cases of hemodialysis and peritoneal dialysis patients from Sep.2012 to Nov.2014 were randomly selected as study objects,in which 39 cases of co-infected patients were selected as observation group,and 48 cases of non-infected patients were selected as control group.The levels of PCT and CRP of the two groups were compared,and the sensitivity and specificity of PCT and CRP and other indicators diagnosis were analyzed,in order to investigate their diagnostic values.RESULTS The PCT level and CRP level of observation group 7days before dialysis had no significant difference compared with control group,while the PCT level and CRP level of the patients in observation group 4days and 1day before dialysis were significantly higher than that of control group（P〈0.05）.The positive rates of PCT and CRP of observation group the patients were 94.9%and 100% The procalcitonin test showed that there were 2cases of patients with the PCT concentration〈1.5ng/mL,31 cases with 1.5~10ng/mL,and 6cases with〉10ng/mL 6cases in observation group;in the control group,there were 48 cases of patients with the PCT concentration 〈1.5ng/mL,and 0case with 1.5~10ng/mL and〉10ng/mL.Totally 37 strains of pathogenic bacteria were isolated from 39 cases of observation group,including 21 strains of gram-positive bacteria,13 strains of gram-negative bacteria and 3 strains of fungi,accounting for 56.9%,35.1%,and 8.1%,respectively.CONCLUSIONPCT and CRP levels have important significance for the diagnosis of patients with infections,and can be used as an important reference for dialysis patients with infections.

关 键 词：感染 透析 降钙素原 C-反应蛋白 

分 类 号：R446[医药卫生—诊断学]