降钙素原对慢性肾脏病5期患者感染的预测价值  

Predictive value of procalcitonin in infection in patients with stage 5 chronic kidney disease

作　　者：孙妍蓓[1] 蒋丽娟[2] 邵小南[3] SUN Yanbei;JIANG Lijuan;SHAO Xiaonan(Department of Nephrology;Department of Clinical Laboratory;Department of Nuclear Medicine,the Third Affiliated Hospital of Soochow University,Changzhou 213003,China)

机构地区：[1]苏州大学附属第三医院肾脏科,江苏常州213003 [2]苏州大学附属第三医院检验科,江苏常州213003 [3]苏州大学附属第三医院核医学科,江苏常州213003

出　　处：《东南大学学报（医学版）》2018年第4期553-559,共7页Journal of Southeast University(Medical Science Edition)

基　　金：国家自然科学基金面上项目(81371513)

摘　　要：目的:探讨降钙素原(PCT)对慢性肾脏病(CKD)5期患者感染的预测价值。方法:将苏州大学附属第三医院肾脏科住院的373例CKD 5期患者分为非感染组、局部感染组和脓毒症组,另选择75例健康成人作为对照组,比较各组临床特点和炎症指标。结果:在CKD 5期,基线PCT、中性粒细胞比例明显高于对照组(均P<0.001)。白细胞计数(WBC)和中性粒细胞比例无法预测局部感染(均P>0.05),PCT和C-反应蛋白(CRP)预测局部感染的ROC曲线下面积(AUC)分别为0.715、0.780,均P<0.05。CRP和WBC无法预测脓毒症(均P>0.05);PCT和中性粒细胞比例预测脓毒症的AUC分别为0.823、0.683,均P<0.05。结论:CKD 5期患者的PCT和中性粒细胞比例水平明显升高;PCT预测局部感染的价值不如CRP,而预测脓毒症价值最优。Objective： To investigate the predictive value of procalcitonin（ PCT） in infection in patients with stage 5 chronic kidney disease. Methods： A total of 373 cases of stage 5 CKD patients who were hospitalized from Department of Nephrology,the Third Affiliated Hospital of Suzhou University were retrospectively analyzed. The patients were divided into non-infected group,local infection group and sepsis group. 75 healthy people were selected as the control group. The clinical characteristics and inflammatory parameters were compared. Results： The baseline PCT and neutrophil percentage in patients with stage 5 CKD were significantly higher than those in the control group（ all P〈0. 001）. In patients with stage 5 CKD,WBC and neutrophil percentage could not predict local infection（ P〈0. 05）. The AUC of PCT and CRP were 0. 715（ P〈0. 001） and 0. 780（ P〈0. 001） for local infection,respectively. CRP and WBC were unable to predict sepsis in patients with stage 5 CKD（ P〈0. 05）. The AUC of PCT and neutrophil percentage were 0. 823（ P〈0. 001） and 0. 683（ P〈0. 001） for sepsis,respectively.Conclusion： Compared with other inflammatory markers,the baseline PCT and neutrophil percentage in patients with stage 5 CKD are significantly higher. In stage 5 CKD phase,the ability of PCT to predict local infection is less than that of CRP,whereas PCT can best predict sepsis.

关 键 词：慢性肾脏病 降钙素原 感染 脓毒症 

分 类 号：R692[医药卫生—泌尿科学]