降钙素原在血液病患者粒细胞缺乏合并细菌血流感染中的临床价值  

Clinical value of procalcitonin in agranulocytosis complicated with bacterial bloodstream infection in patients with hematological diseases

作　　者：郑志海[1] 廖丽昇[1] 谢颖[1] 曲双[1] 杨彤 陈碧云[1] ZHENG Zhihai;LIAO Lisheng;XIE Ying;QU Shuang;YANG Tong;CHEN Biyun(Department of Hematology,Fujian Provincial Hospital,Fuzhou 350001,China)

机构地区：[1]福建省立医院血液科,福建福州350001

出　　处：《中国现代医生》2021年第16期134-136,141,共4页China Modern Doctor

摘　　要：目的探讨降钙素原(PCT)在血液病患者粒细胞缺乏合并细菌血流感染中的临床评估及感染转归预测价值。方法回顾性分析2016年1月至2019年12月福建省立医院血液科住院的650例血液病患者合并细菌感染的临床资料,送检血培养标本,同时检测血清PCT,根据血培养结果将样本分为血培养阳性组68例和血培养阴性组582例;再将血培养阳性组分为革兰阴性菌感染组50例与革兰阳性菌感染组18例,统计并研究PCT水平的不同,以及与患者发生感染性休克、多脏器功能障碍和感染相关性死亡的相关性。结果血培养阳性组的PCT水平高于血培养阴性组(P=0.000),革兰阴性菌组PCT水平高于革兰阳性菌组(P=0.000),血流感染患者发生感染性休克及其他严重并发症比例随血清PCT水平增高而增高,差异有统计学意义(P=0.000)。结论血清PCT在血液病粒细胞缺乏血流感染者较非血流感染者显著上升,可作为早期评估指标,PCT可作为血液病患者粒细胞缺乏合并细菌血流感染预后判断的重要指标。Objective To investigate the clinical evaluation of procalcitonin(PCT)in agranulocytosis complicated with bacterial bloodstream infection in patients with hematological diseases and the predictive value of infection outcome.Methods The clinical data of 650 patients with hematological diseases complicated with bacterial infection admitted to the Department of Hematology,Fujian Provincial Hospital from January 2016 to December 2019 were analyzed retrospectively.Blood culture specimen were sent for examination,and serum PCT was detected.According to the blood culture results,the samples were divided into the blood culture positive group(n=68)and the blood culture negative group(n=582).Then the blood culture positive group was divided into the Gram-negative bacteria infection group(n=50)and the Gram-positive bacterial infection group(n=18).The difference of PCT level and its correlation with infective shock,multiple organ dysfunction and infection-related death were statistically researched.Results The PCT level in blood culture positive group was higher than that in the blood culture negative group(P=0.000),and that in the Gram-negative bacteria group was higher than that in the Gram-positive bacteria group(P=0.000).The proportion of infective shock and other severe complications in patients with bloodstream infection increased with the growth of serum PCT level,with statistically significant difference(P=0.000).Conclusion Serum PCT in patients with hematological diseases of agranulocytosis and bloodstream infection is significantly higher than that in patients without bloodstream infection,which can be used as an early evaluation index.PCT can be used as an important index to judge the prognosis in patients with hematological diseases of agranulocytosis complicated with bacterial bloodstream infection.

关 键 词：血液病 血流感染 降钙素原 感染性休克 

分 类 号：R446.6[医药卫生—诊断学]