2型糖尿病患者发生急性血流感染的预测指标分析  

Predictors of acute bloodstream infections in patients with type 2 diabetes mellitus

作　　者：马丽平 崔北辰 关岚[1] 王聪[1] 赵斌[1] Ma Liping;Cui Beichen;Guan Lan;Wang Cong;Zhao Bin(Department of Emergency,Beijing Jishuitan Hospital,Beijing 100035,China)

机构地区：[1]北京积水潭医院急诊科,北京100035

出　　处：《中国医刊》2021年第9期972-975,共4页Chinese Journal of Medicine

摘　　要：目的探讨血清降钙素原(serum procalcitonin,PCT)、血乳酸对2型糖尿病患者发生急性血流感染的预测价值。方法回顾性分析北京积水潭医院急诊科2018年1月1日至2019年12月31日收治的339例临床诊断为急性血流感染并抽取血培养的2型糖尿病患者的病例资料,根据血培养结果分为血培养阳性组(113例)和血培养阴性组(226例)。记录两组患者的PCT和血乳酸水平,并分析PCT、血乳酸及PCT联合血乳酸对2型糖尿病患者血培养阳性的预测价值。结果血培养阳性组患者的PCT和血乳酸水平明显高于血培养阴性组,差异有显著性(P<0.05)。受试者工作特征曲线显示PCT联合血乳酸曲线下面积为0.875,高于PCT的0.801和血乳酸的0.796。通过受试者工作特征曲线分析以PCT 1.79μg/L、血乳酸2.35mmol/L为截断值,PCT联合血乳酸对2型糖尿病患者血培养阳性预测的敏感度、特异度、阳性预测值和阴性预测值均高于PCT和血乳酸。结论PCT及血乳酸可作为预测2型糖尿病患者发生急性血流感染的可靠指标,可为急诊科医师的临床诊断与治疗提供有效参考,值得临床应用。Objective To investigate the predictive value of serum procalcitonin(PCT)and blood lactic acid in acute blood stream infection in patients with type 2 diabetes mellitus.Method The clinical datas of 339 patients with type 2 diabetes mellitus who were clinically diagnosed as blood stream infection and blood cultured were analyzed from January 1st 2018 to December 31th 2019 in Beijing Jishuitan Hospital.According to the results of blood culture,they were divided into blood culture positive group(113 cases)and blood culture negative group(226 cases).The levels of PCT and blood lactic acid were recorded,and the predictive value of PCT,blood lactic acid and PCT combined with blood lactic acid on positive blood culture in patients with type 2 diabetes mellitus was analyzed.Result The levels of PCT and blood lactic acid in blood culture-positive group were significantly higher than those in blood culture-negative group(P<0.05).The receiver operating characteristic(ROC)curve showed that the area under the curve of PCT combined with blood lactic acid was 0.875,which was higher than that of PCT(0.801)and blood lactic acid(0.796).By ROC curve analysis,PCT 1.79μg/L and blood lactic acid 2.35mmol/L were taken as the cut-off values.The sensitivity,specificity,positive predictive value and negative predictive value of PCT combined with blood lactic acid for positive prediction of blood culture in patients with type 2 diabetes mellitus were higher than those of PCT and blood lactic acid.Conclusion PCT and serum lactic acid can be used as a reliable index to predict acute bloodstream infection in patients with type 2 diabetes,and can provide effective reference for the clinical diagnosis and treatment of emergency department physicians,which is worthy of clinical application.

关 键 词：2型糖尿病 血清降钙素原 血乳酸 血培养 血流感染 

分 类 号：R63[医药卫生—外科学]