血液及尿液中降钙素原(PCT)检测在泌尿系统感染定位中的诊断价值  

Diagnostic Value of Detecting the Serum and Urine Procalcitonin(PCT)for the Urinary System Infection

作　　者：严海忠[1] 王伟佳[1] 慕月晶[1] 徐全中[1] 

机构地区：[1]中山大学附属中山医院检验医学中心,广东中山528403

出　　处：《现代检验医学杂志》2017年第4期116-118,共3页Journal of Modern Laboratory Medicine

摘　　要：目的探讨血液及尿液中降钙素原(procalcitonin,PCT)检测在泌尿系统感染定位中的诊断价值。方法选取中山市人民医院2016年3月~11月门诊及住院明确诊断的泌尿系统感染患者45例(排除其它系统感染),按照上、下尿路感染诊断标准分为上尿路感染组21例,下尿路感染组24例。正常对照组为同期在该院体检的35例健康成人。在Cobas E601电化学发光免疫检测系统上检测其血清和尿液PCT水平,分析上、下尿路感染组及正常对照组之间的差异。结果上尿路感染组尿液PCT水平为0.243±0.123 ng/ml,显著低于下尿路感染组0.486±0.232 ng/ml和正常对照组0.454±0.253 ng/ml,差异有统计学意义(t=4.11,P=0.000;t=3.96,P=0.000);上尿路感染组血清PCT水平为0.062±0.014ng/ml,明显高于下尿路感染组0.043±0.020 ng/ml和正常对照组0.032±0.013 ng/ml,差异有统计学意义(t=3.56,P=0.01);3组尿液PCT水平都显著高于其血清PCT,差异有统计学意义(t=9.48,9.12,6.79,P值均<0.01);血清PCT对上尿路感染诊断的敏感度为81.5%,特异度为84.2%,阳性预测值为80.6%,阴性预测值为85.6%;尿液PCT对上尿路感染诊断的敏感度为86.4%,特异度为80.7%,阳性预测值为88.4%,阴性预测值为83.1%。结论血清PCT和尿液PCT检测对于临床尽早鉴别上下尿路感染有重要辅助诊断价值。Objective To explore diagnostic value of the serum and urine proealcitonin （PCT） detecting in the urinary system infection. Methods The serum and urine PCT levels in 45 urinary system infection patients with clear pathological diagnosis （exclude other system infections ） who were outpatiented or hospitalized in the People＇s Hospital of Zhongshan between March and November 2016 （including 21 eases of upper urinary tract infection and 24 cases of lower urinary tract infection） and 35 healthy adults who went through physical examinations at the hospital during the same period, were measured using electrochemiluminescence immunoassay （ECLIA） on Cobase 601 Immunoassay Analyzer and analyzed to compare the differ- ences of PCT levels in the three groups. Results The urine PCT level in upper urinary tract infection group was 0. 243 ± 0. 123 ng/ml. It was significantly lower than lower urinary tract infection group （0. 486± 0. 232 ng/ml, t= 4.11 ,P= 0. 000） and control group （0. 454±0. 253 ng/ml,t=3.96,P=0. 000）. The serum PCT level in upper urinary tract infection group was 0. 062±0. 014 ng/ml. It was obviously higher than that in lower urinary tract infection group （0. 043±0. 020 ng/ml,t= 3.56,P=0.01） and control group （0.032±0. 013 ng/ml,t=7.38,P=0. 000）. In all groups,the urine PCT levels were sig- nificantly higher than their serum PCT levels （t = 9.48,9.12,6.79, P〈0.01）, and significant differences were observed in them. The sensitivity,specificity, positive predictive value and negative predictive value of serum PCT for diagnosing upper urinary tract infections were 81.5%,84.2%,80.6% and 85.6% respectively, and the urine PCT were 86.4%,80.7%, 88.4% and 83.1 % respectively. Conclusion Detection of serum and urine PCT has important accessory diagnostic value for identifying upper and lower urinary tract infections.

关 键 词：降钙素原 泌尿系统感染 诊断价值 

分 类 号：R691.3[医药卫生—泌尿科学] R392.11[医药卫生—外科学]