血清降钙素原在感染性发热诊断中应用价值.docVIP

血清降钙素原在感染性发热诊断中应用价值 　　[摘要] 目的 分析感染性发热患者中细菌感染与非细菌感染血清降钙素原（PCT）水平的差别，探讨血清PCT在感染性发热疾病诊断中的应用价值。方法 前瞻性地纳入73例发热查因的急诊和住院患者，采血测定PCT、CRP和血常规，同时通过病原学或血清免疫学检测明确诊断，比较各指标对细菌感染的诊断价值。结果 通过细菌感染组与非细菌感染组的PCT、CRP和白细胞总数的比较，差异有统计学意义，细菌感染组的各项指标均显著高于非细菌感染组（P0.01）。PCT对发热患者细菌感染诊断的敏感性为93.0%，特异性为83.3%，均高于CRP的敏感性（81.4%）和特异性（56.7%）与白细胞的敏感性（76.7%）和特异性（53.3%）。结论 采取PCT的检测能更有效的鉴别急诊发热患者的细菌感染与非细菌感染，且有更好的敏感性和特异性造词，有助于早期的正确诊断、治疗及用药。 　　[关键词] 感染；发热；降钙素原；C-反应蛋白；白细胞 　　[中图分类号] R4 [文献标识码] A [文章编号] 1674-0742（2014）03（b）-0032-03 　　[Abstract] Objective To analyze the different procalcitonin（PCT）levels in serum between fever patients with bacterial infection and fever patients with non-bacterial infection， and explore the significance of PCT in the diagnosis of infectious fever.Methods 73 emergency patients and hospitalized patients with fever were studied prospectively. Their blood samples were taken to test PCT， C-reactive protein（CRP）and blood routine. And etiology or serum immunological test was performed for diagnosis. The values of all test results for diagnosis of bacterial infection were compared.Results PCT，CRP and white blood cell in bacterial infection group were all higher than those of non-bacterial infection group， the differences were statistically significant（P0.01）.The sensitivity and specificity of PCT was 93.0% and 83.3% respectively， and it had a higher diagnostic value than CRP（81.4%， 56.7%）and white blood cell （76.7%， 53.3%） in fever patients with bacterial infection.Conclusion PCT test is more helpful to identify whether the fever patients with bacterial infection or non-bacterial infection. It has good sensitivity and specificity， and is conducive to early diagnosis， treatment and medication. 　　[Key words] Infection； Fever； Procalcitonin； C-reactive protein； White blood cell 　　临床上，引起发热的最常见原因是感染性发热，病原体包括细菌、病毒、寄生虫等。病原分离是感染诊断的金标准，但需要一定的时间和设备，还有一部分病原体在实验室不能分离。故，寻找快速有效的实验方法鉴别诊断早期细菌感染和非细菌感染，对于及时针对性治疗疾病，防止疾病恶化显得十分必要。该研究选择2012年7月―2013年2月在番禺中心医院就医的发热查因的患者73例作为研究对象，旨在探讨血清降钙素原（procalcitonin，PC