降钙素原联合血培养在脓毒症早期诊疗中的临床价值  

The Clinical Significance of Procalcitonin Combined with Blood Culture in the Early Stage of Diagnosis and Treatment of Sepsis

作　　者：刘伟[1] 李云峰 林兆恒[2] 李婷婷[3] LIU Wei;LI Yun-feng;LIN Zhao-heng;LI Ting-ting(Department of Laboratory;Department of Intensive Care Unit;Department of Pharmacy, the People＇s Hospital of Xishuangbanna Dai Autonomous Prefecture, Xishuangbanna 666100, China)

机构地区：[1]西双版纳州人民医院检验科,云南西双版纳666100 [2]西双版纳州人民医院重症医学科,云南西双版纳666100 [3]西双版纳州人民医院药学部,云南西双版纳666100

出　　处：《标记免疫分析与临床》2018年第5期650-653,共4页Labeled Immunoassays and Clinical Medicine

摘　　要：目的探讨降钙素原(procalcitonin;procalcitonin,PCT)与血培养在临床脓毒症诊疗中的应用价值。方法回顾性分析西双版纳傣族自治州人民医院2014年1月至2016年4月疑似脓毒症并在入院早期进行了血培养和PCT检测的500例患者,按SCCM/ESICM诊断标准分为脓毒症组和普通感染组,比较两组患者血培养和PCT检测结果。结果 162例患者进入脓毒症组,338例进入普通感染组。脓毒症组和普通感染组血培养阳性率分别为45.68%和25.44%,PCT阳性率分别为91.97%和36.98%,两组差异均具有统计学意义(P<0.01);脓毒症组及普通感染组PCT均值分别为6.37±1.61ng/m L和0.22±0.43ng/m L,差异具有统计学意义(P<0.01)。PCT>2ng/m L时,血培养中革兰氏阳性菌主要为凝固酶阴性葡萄球菌和金黄色葡萄球菌,革兰氏阴性菌主要为大肠埃希菌和肺炎克雷伯菌。结论降钙素原与血培养联合检测在脓毒症早期鉴别诊断中有一定的应用价值,对于早期制定抗感染治疗方案有一定的指导价值。Objective To investigate the values of procalcitonin （PCT） and blood culture in the clinical diagnosis and treatment of sepsis. Methods A retrospective analysis of 500 patients with suspected sepsis in People＇s Hospital of Xishuangbanna Dai Autonomous Prefecture from January 2014 to April 2016 was conducted, and all those patients had undergone blood culture and PCT testing in the early stage of admission. All patients were divided into sepsis groups and common infection group as control according to the SCCM/ ESICM diagnostic criteria, and then, blood culture and PCT testing results were compared between the two groups. Results 162 patients were enrolled into the sepsis group and 338 patients were enrolled into the common infection group. The positive rates of blood culture in the sepsis group and the common infection group were 45.68% and 25.44%, respectively, and the PCT positive rates were 91.97% and 36.98%, respectively. There is a statistically significant difference between the two groups(P 〈 0.01). The mean PCT values in sepsis group and common infection group were 6.37 ± 1.61 ng/mL and 0.22 ± 0.43 ng/mL, respectively, and the difference was statistically significant(P 〈 0.01). In the condition of PCT 〉 2ng/mL, Gram-positive bacteria in blood culture were mainly coagulase-negative staphylococci and Staphylococcus aureus,while Gram-negative bacteria were mainly Escherichia coli and Klebsiella pneumoniae. Conclusion The combined detection of procalcitonin and blood culture has promising values in the differential diagnosis of sepsis. It has guiding significance for the early development of anti-infective treatment programs.

关 键 词：降钙素原 脓毒症 血培养 诊疗 

分 类 号：R446.1[医药卫生—诊断学] R459.7[医药卫生—临床医学]