不同脓毒症诊断标准中降钙素原的临床意义  

Role of procalcitonin in the diagnosis of different sepsis

作　　者：潘锡龙 徐志远 谢锋 李丹 PAN Xilong;XU Zhiyuan;XIE Feng;LI Dan(Department of Clinical Laboratory,Dongsheng Hospital of Zhongshan City,Zhongshan 528414,Guangdong,China;Department of Critical Care Medicine,Dongsheng Hospital of Zhongshan City,Zhongshan 528414,Guangdong,China;Department of Internal Medicine,Dongsheng Hospital of Zhongshan City,Zhongshan 528414,Guangdong,China)

机构地区：[1]中山市东升医院检验科,广东中山528414 [2]中山市东升医院重症医学科,广东中山528414 [3]中山市东升医院内科,广东中山528414

出　　处：《检验医学》2021年第12期1215-1218,共4页Laboratory Medicine

摘　　要：目的明确降钙素原(PCT)在脓毒症诊断标准由Sepsis-1变为Sepsis-3时,诊断效能的差异,为临床诊断脓毒症提供参考。方法选取189例有感染或/和全身炎症反应综合征(SIRS)表现的患者,并根据病情将其分为脓毒症组、非脓毒症组、脓毒性休克组,以30名健康体检者作为对照组,检测所有研究对象PCT水平。采用受试者工作特征(ROC)曲线评价采用Sepsis-1和Sepsis-3标准时PCT诊断脓毒症的效能。结果不同诊断标准中,对照组、非脓毒症组、脓毒症组、脓毒性休克组PCT水平呈逐渐上升趋势(P<0.05)。采用Sepsis-1和Sepsis-3诊断标准,PCT诊断脓毒症的曲线下面积分别为0.85、0.73,敏感性分别为76.85%和57.01%,特异性分别为78.38%和76.79%;PCT诊断脓毒性休克中的曲线下面积分别为0.75、0.76,敏感性分别为73.91%、64.86%,特异性分别为80.65%和81.43%。结论脓毒症诊断标准由Sepsis-1变为Sepsis-3,PCT的诊断效能有所下降,但对脓毒性休克的诊断效能无变化。Objective To investigate the specific changes in the diagnostic efficacy of procalcitonin(PCT)when the diagnostic criteria for sepsis changed from Sepsis-1 to Sepsis-3,and to provide a reference for the clinical application of PCT in the diagnosis of sepsis. Methods A total of 189 patients with infection or(and) the manifestations of systemic inflammatory response syndrome(SIRS)(non-sepsis,sepsis and septic shock groups)and 30 healthy subjects(healthy control group)were enrolled. PCT was determined in all the subjects. Receiver operating characteristic(ROC) curves were used to evaluate the roles of Sepsis-1 and Sepsis-3 for the diagnosis of PCT. Results There was an increasing trend in PCT levels from healthy control,non-sepsis,sepsis to septic shock groups in each diagnostic component(P<0.05). Based on Sepsis-1 and Sepsis-3 diagnostic criteria,the areas under curves were 0.85 and 0.73,the sensitivities were 76.85% and 57.01%,the specificities were 78.38% and 76.79%,respectively. The areas under curves,sensitivities and specificities of PCT in the diagnosis of septic shock were 0.75 and 0.76,73.91% and 64.86%,80.65% and 81.43%,respectively. Conclusions When the diagnostic criteria for sepsis change from Sepsis-1 to Sepsis-3,the diagnostic efficacy of PCT decreases in the diagnosis of sepsis,and the diagnostic efficacy of PCT does not change in the diagnosis of septic shock.

关 键 词：降钙素原 脓毒症 Sepsis-1 Sepsis-3 

分 类 号：R446.1[医药卫生—诊断学]