降钙素原对亚急性甲状腺炎合并细菌感染的诊断价值  

The value of procalcitonin in the diagnosis of subacute thyroiditis complicated with bacterial infections

作　　者：李睿[1] 熊大迁[1] 辛力华[1] 任然[1] 张琼芳[1] LI Rui;XIONG Daqian;XIN Lihua;REN Ran;ZHANG Qiongfang(The Affiliated Hospital of Chengdu University of Traditional Chinese medicine, Chengdu 610075, China)

机构地区：[1]成都中医药大学附属医院,四川成都610075

出　　处：《西部医学》2021年第10期1492-1495,1499,共5页Medical Journal of West China

基　　金：四川省科技厅重点研发项目(2020YFS0375)。

摘　　要：目的探讨降钙素原(PCT)对亚急性甲状腺炎(SAT)合并细菌感染的诊断价值。方法选取2017年6月~2019年6月我院收治的195例SAT患者,根据是否合并细菌感染将其分为感染组(n=72)和非感染组(n=123),另选取同期健康志愿者100例作为对照组。对三组患者的白细胞计数(WBC)、中性粒细胞百分比(NE%)、红细胞沉降率(ESR)及血清游离三碘甲状原氨酸(FT3)、游离甲状腺素(FT4)、C反应蛋白(CRP)、PCT水平进行检测和比较。采用受试者工作特征(ROC)曲线分析各项指标在SAT合并细菌感染诊断中的价值。结果感染组与非感染组患者的血清FT3、FT4、CRP水平及ESR水平的差异无统计学意义(P>0.05),但均高于对照组,差异均有统计学意义(P<0.05);感染组患者的WBC、NE%水平均高于非感染组或对照组,非感染组患者的WBC、NE%水平均高于对照组,差异均有统计学意义(P<0.05);感染组患者的血清PCT水平高于非感染组或对照组,差异均有统计学意义(P<0.05),而非感染组患者与对照组血清PCT水平的差异无统计学意义(P>0.05)。ROC曲线所示:PCT的AUC最大,在Cutoff值下,灵敏度和特异度分别达到0.861和1.000。结论SAT合并细菌感染患者的血清PCT水平会出现显著升高,其对于病原学鉴别诊断的价值高于WBC等常规感染指标,可用于辅助指导针对SAT患者的抗菌药物应用。Objective To analyze the value of procalcitonin(PCT)in the diagnosis of subacute thyroiditis(SAT)complicated with bacterial infections.Methods 195 patients with SAT from June of 2017 to June of 2019 were divided into the infection group(72 cases)and the non infection group(123 cases)according to whether they were complicated with bacterial infections.100 healthy volunteers in the same period were selected as the control group.The white blood cell(WBC),the percentage of neutrophils(NE%),the erythrocyte sedimentation rate(ESR),the serum levels of free triiodothyronine(FT3),free thyroxine(FT4),C-reactive protein(CRP)and PCT were detected and compared among the three groups.The receiver operating characteristic(ROC)curve was used to analyze the value of each index in the diagnosis of SAT complicated with bacterial infections.Results There were no significant differences of the serum FT3,FT4,CRP levels and ESR between the patients in the infection group and the non infection group(P>0.05),but those were higher than those in the control group(P<0.05).The WBC and NE%levels of the patients in the infection group were higher than those in the non infection group or the control group,and the WBC and NE%levels of the patients in the non infection group were higher than those in the control group(P<0.05).The level of serum PCT of the patients in the infection group was higher than that in the non infection group or the control group(P<0.05),but there was no significant difference between the non infection group and the control group(P>0.05).The ROC curve analysis showed that the AUC of PCT was the largest,and the sensitivity and specificity of PCT reached 0.861 and 1.000 respectively under the Cutoff value.Conclusion The serum PCT level of SAT patients complicated with bacterial infections increases significantly,which is more valuable for etiological differential diagnosis than the other conventional infection indicators such as WBC.

关 键 词：降钙素原 亚急性甲状腺炎 细菌感染 诊断 受试者工作特征曲线 

分 类 号：R581.4[医药卫生—内分泌]