PCT测定联合微生物培养在呼吸内科ICU患者中应用价值.docVIP

PCT测定联合微生物培养在呼吸内科ICU患者中应用价值 　　[摘要] 目的 探讨血清降钙素原（PCT）测定联合微生物培养在呼吸内科ICU患者中的应用价值。 方法 对我院2014年1月～2015年1月呼吸内科ICU收治的300例患者的PCT检测结果和微生物培养结果进行回顾性分析。 结果 300例患者PCT检测阳性235例，检测阳性率为78.3%；微生物培养共分离出病原菌57株（革兰氏阳性球菌9株，革兰氏阴性杆菌29株，真菌19株），阳性率为19.0%，PCT检测阳性率明显高于微生物培养检测，差异有统计学意义（P0.05）。PCT的灵敏度和特异度分别为89.5%（51/57）、24.3%（59/243），阳性预测值为21.7%（51/235），阴性预测值为90.8%（59/65）。微生物培养的29例革兰氏阴性杆菌中有23例血清PCT≥0.05 ng/ml，阳性比例为79.3%；9例革兰氏阳性球菌中有7例血清PCT≥0.05 ng/ml，阳性比例为77.8%；19例真菌阳性患者中有8患者血清PCT≥0.05 ng/ml，阳性比例为33.3%。 结论 血清PCT检测结合微生物培养可用于早期评估呼吸内科ICU患者的感染状况，及时为临床提供感染依据，指导临床用药，有助于医生早期诊断及确定治疗方案。 　　[关键词] 降钙素原；微生物培养；细菌感染；早期诊断 　　[中图分类号] R459.7 [文献标识码] A [文章编号] 1674-4721（2016）04（c）-0134-03 　　Application value analysis of PCT determination and microculture in respiratory medicine ICU patients 　　WEI Hui-ling 　　Department of Laboratory Medicine，Zhengzhou Seventh People′s Hospital，Zhengzhou 450000，China 　　[Abstract] Objective To explore the application value of PCT determination and microculture in respiratory medicine ICU patients. Methods PCT determination and microculture results of 300 cases from January 2014 to January 2015 of respiratory medicine in our hospital were analyzed retrospectively. Results Among 300 patients，235 cases had the positive PCT determination and the determination positive rate was 78.3%.57 strains were isolated from microculture and the positive rate was 19.0%，among that，9 strains were gram-positive coccus，29 strains were gram-negative coccus and 19 strains were fungus.The positive rate of PCT determination was obvious higher than microbiological detection （P0.05）.The sensitivity and specificity of PCT were respectively 89.5% （51/57） and 24.3% （59/243）；the positive predicted value and negative predicted value were respectively 21.7% （51/235） and 90.8% （59/65）.Serum PCT of 23 cases was more than 0.05 ng/ml among microcultured 29 gram-negative coccus and the positive rate was 79.3%.Serum PCT of 7 cases was more than 0.05 ng/ml among microcultured 9 gram-positive coccus and the positive rate