血清降钙素原在急诊感染患者细菌感染病原学分型中的价值分析  

Value of serum procalcitonin in the pathogenic classification of bacterial infection in emergency patients

作　　者：毛小强 陈毓[1] 金晶[2] MAO Xiao-qiang;CHEN Yu;JIN Jing(Department of Emergency,Quzhou People's Hospital,Quzhou,Zhejiang 324000,China;不详)

机构地区：[1]衢州市人民医院急诊科,浙江衢州324000 [2]衢州市人民医院普外科

出　　处：《中华全科医学》2022年第1期65-67,75,共4页Chinese Journal of General Practice

基　　金：浙江省医药卫生科技计划项目(2017KY699)。

摘　　要：目的探究血清降钙素原(PCT)在急诊感染患者细菌感染病原学分型中的价值,为临床抗菌治疗合理用药提供参考依据。方法选择2016年1月-2020年6月衢州市人民医院急诊科诊治的感染患者240例,同时在体检中心选择120名健康受试者纳入研究。酶联免疫反应定量检测血清PCT浓度,通过设计诊断试验全面评价PCT在急诊感染患者细菌感染病原学分型中的价值:对照组和细菌感染者诊断试验;革兰氏染色阳性与阴性患者诊断试验。结果细菌感染组血清PCT浓度高于对照组水平(P<0.05),革兰氏染色阴性组PCT浓度显著高于革兰氏染色阳性组(P<0.05)。细菌感染组与对照组进行诊断试验结果显示:AUC曲线下面积为0.978(95%CI:0.958~0.991,P<0.001),灵敏度为91.5%,特异度为99.4%,PCT最佳截断值为1.36 ng/mL;G+组与G-组间诊断试验结果:AUC曲线下面积为0.817(95%CI:0.757~0.868,P<0.001),灵敏度为80.0%,特异度为97.3%,PCT最佳截断值为3.61 ng/mL。结论血清PCT为良好的细菌病原学分型的生物标记物,能够为急诊抗菌药物的合理使用提供参考依据。Objective To explore the value of serum procalcitonin(PCT)in the pathogen classification of bacterial infection in emergency patients and to provide reference for rational drug use in clinical antibacterial treatment.Methods A total of 240 infectious patients were selected in the Emergency Department of our hospital,and 120 healthy people were also selected for this study in the physical examination centre.Enzyme-linked immunosorbent assay was used to quantitatively detect serum PCT concentration.The diagnostic test was designed to comprehensively evaluate the value of PCT in the pathogen classification of bacterial infection in emergency patients,including the diagnostic test in the control group and bacterial infection group,diagnostic tests in gram-positive and gram-negative patients.Results The concentration of serum PCT was higher in the bacterial infection group than in the control group(P<0.05).The PCT concentration in the gram-negative group was significantly higher than that in the gram-positive group.Results of diagnostic test between the bacterial infection and control groups showed that the area under AUC curve was 0.978(95%CI:0.958-0.991,P<0.001),with a sensitivity of 91.5%and a specificity of 99.4%on the best cut-off value of 1.36 ng/mL.Diagnostic test results between gram-positive and gram-negative bacterial infection patients were that the area under AUC curve was 0.817(95%CI:0.757-0.868,P<0.001),with a sensitivity of 80.0%and a specificity of 97.3%when the best cut-off value was 3.61 ng/mL.Conclusion Serum PCT is a good biomarker for pathogen classification in bacterial infection,and it may serve as a reference for the rational use of antibacterial drugs.

关 键 词：血清降钙素原 感染 细菌 病原学分型 

分 类 号：R63[医药卫生—外科学] R446.5[医药卫生—临床医学]