血清降钙素原在泌尿系感染并发脓毒血症早期诊断中的应用价值研究  

The value of serum procalcitonin in the early diagnosis of urinary tract infection complicated with sepsis

作　　者：庄雯雯[1] ZHUANG Wen-wen(Department of Physician,Huizhou Central People’s Hospital,Huizhou 516001,China)

机构地区：[1]广东省惠州市中心人民医院内科,516001

出　　处：《中国实用医药》2020年第20期40-42,共3页China Practical Medicine

摘　　要：目的探讨血清降钙素原(PCT)在泌尿系感染并发脓毒血症早期诊断中的应用价值。方法78例确诊为泌尿系感染患者,根据病理诊断是否并发脓毒血症分为脓毒血症组(32例)和非脓毒血症组(46例)。检测并比较两组患者的血清PCT、超敏C反应蛋白(hs-CRP)、外周血白细胞计数(WBC)水平,根据受试者工作曲线(ROC)分析比较血清PCT、hs-CRP、外周血WBC检测脓毒血症的敏感度、特异度。结果脓毒血症组血清PCT、hs-CRP分别为(9.37±3.48)μg/L、(128.59±45.39)mg/L,均高于非脓毒血症组的(1.06±0.93)μg/L、(101.38±34.93)mg/L,差异有统计学意义(P<0.05)。两组外周血WBC水平比较差异无统计学意义(P>0.05)。PCT的曲线下面积(AUC)为0.938[95%CI(0.84,0.96)],hs-CRP和WBC的AUC分别为0.695和0.621;PCT的最佳截断点为3.52μg/L,此时的敏感度为87.1%,特异度为91.7%,hs-CRP、WBC在最佳截断点的敏感度和特异度均<70.0%。结论PCT对泌尿系感染患者并发脓毒血症有较高的敏感度和特异度,可作为怀疑泌尿系感染并发脓毒血症时的常规检测指标,有利于早期诊断。Objective To discuss the value of serum procalcitonin(PCT)in the early diagnosis of urinary tract infection complicated with sepsis.Methods A total of 78 patients with urinary tract infection were divided into sepsis group(32 cases)and non-sepsis group(46 cases)according to pathological diagnosis.The serum PCT,high-sensitivity C-reactive protein(hs-CRP),and peripheral white blood cell(WBC)count of the two groups were detected and compared.The sensitivity and specificity of serum PCT,hs-CRP,and peripheral WBC in detecting sepsis were compared according to the receiver operating curve(ROC).Results The serum PCT and hs-CRP of sepsis group were(9.37±3.48)μg/L and(128.59±45.39)mg/L respectively,which were all higher than those of the non-sepsis group(1.06±0.93)μg/L and(101.38±34.93)mg/L,and the difference was statistically significant(P<0.05).There was no statistically significant difference in peripheral WBC level between the two groups(P>0.05).The area under curve(AUC)of PCT in sepsis group was 0.938[95%CI(0.84,0.96)],which were 0.695 and 0.621 of hs-CRP and WBC.The best cut-off point of PCT was 3.52μg/L.At this time,the sensitivity was 87.1%and the specificity was 91.7%.The sensitivity and specificity of hs-CRP and WBC at the best cut-off point were less than 70.0%.Conclusion PCT has a high sensitivity and specificity to the patients with urinary tract infection complicated with sepsis.It can be used as a routine detection index when suspecting urinary tract infection complicated with sepsis,which is conducive to early diagnosis.

关 键 词：降钙素原 泌尿系感染 脓毒血症 超敏C反应蛋白 

分 类 号：R459.7[医药卫生—急诊医学] R691.3[医药卫生—治疗学]