降钙素原在不同感染部位和类型中的应用价值  

Application of Procalcitonin in Different types of Infection

作　　者：赵志鹏[1] 王利君[1] 李润清 李晓晨 宫丽君 赵秀英[1] 

机构地区：[1]清华大学附属北京清华长庚医院,清华大学临床医学院检验科,北京102218

出　　处：《中国实验诊断学》2017年第12期2112-2115,共4页Chinese Journal of Laboratory Diagnosis

基　　金：北京清华长庚医院研究基金资助(项目编号:12015C1040)

摘　　要：目的探讨降钙素原(PCT)在不同感染部位和类型中的应用价值。方法选取同步进行细菌培养和PCT检测的非重复病例679例,其中血流播散性感染组(BSI)94例,腹腔感染组(AI)48例,泌尿系统感染组(UTI)354例、呼吸系统感染(RI)174例、中枢神经系统感染(NI)9例。酶联免疫荧光法检测PCT。结果 BSI组、AI组、UTI组和RI组PCT>0.50μg/L者的百分比和PCT中位值分别为(87.23%,M=4.39μg/L)、(81.25%,M=0.85μg/L)、(20.62%,M=0.05μg/L)、(35.63%,M=0.20μg/L);9例NI者PCT检测值均<0.50μg/L。尿液培养为支原体的病例42例,PCT检测值均<0.50μg/L。PCT≥10.00μg/L的38例中35例培养结果均有革兰阴性杆菌(GNB)。结论 PCT在不同部位感染时升高比率不同,检测值也不同。以血流播散性感染(BSI)和腹腔内感染(AI)升高率和检测值最高;革兰阴性杆菌(GNB)较革兰阳性球菌(GPC)更倾向于刺激机体产生高水平的PCT,PCT≥10.00μg/L提示GNB感染的可能性较大;中枢神经系统感染(NI)和支原体引起的泌尿系统感染不适合用PCT监测。Objective To investgate the application of procalcitonin（PCT）in different types of infection.Methods 679 cases which corresponding to culture for bacterium and to test for PCT.Include 94 cases with bloodstream infection （BSI）,48 cases with intra-abdominal infection （AI）,354 cases with urinary tract infection（UTI）,174 cases with respir-atory infection（RI）,9 cases with central nervous system infection（NI）.Serum PCT levels were determined by Enzyme-linked immune fluorescence.Results The percentages of cases which PCT〉0.50 μg/L and the medians of BSI、AI、UTI and RI respectively（81.91%,M = 4.39 μg/L）,（81.25%,M = 0.85 μg/L）,（20.62%,M = 0.05 μg/L）, （35.63%,M=0.20 μg/L）.All of the 9 NI cases,showed PCT 〈0.50 μg/L.All of the 42 UTI cases ,which mycoplas-ma culture positive,showed PCT 〈 0.50 μg/L.In all cases,38 with PCT 〉 10.00 μg/L,while,Including 35 cases which cultrue results were GNB.Conclusion The positive percentages and levels of PCT are different in different types of infection,BSI and AI showed higher positive percentages and PCT level,GNB are more likely to stimulate the body to produce higher levels of PCT than GPC,When the PCT≥10.00μg/L usually forecast GNB infection,PCT is not suit-able for NI and UTI which caused by mycoplasma.

关 键 词：降钙素原 血流播散性感染 血培养 泌尿系统感染 

分 类 号：R446.6[医药卫生—诊断学]