血清降钙素原检测在细菌性感染疾病早期诊断中的临床应用.docVIP

血清降钙素原检测在细菌性感染疾病早期诊断中的临床应用 【摘要】目的探讨血清降钙素原（PCT）检测在细菌性感染疾病早 期诊断中的临床应用价值。 方法 选取347例感染性疾病患者为研究对象，根据病原学和血清免 疫学确诊实验分为细菌性感染组（212例）和病毒性感染组（135例）。采 用ATB细菌鉴定分析系统进行细菌培养及鉴定；采用乳胶增强免疫散射比 浊法在罗氏Cobas E411型全口动电化学发光免疫分析仪上测定血清PCT 和C反应蛋白（CRP）水平；统计对比分析各组指标的检测结果。 结果 细菌性感染组中，PCT检测结果阳性率为86.79%,明显高于病 毒性感染组的6. 67% （ x 2=214. 519, P0. 001）,且与细菌培养结果比较差 异无统计学意义（x 2二0.125, P=0.724）o ROC曲线分析结果显示,CRP、 PCT、WBC 及 ESR 的 ROC 曲线下面积分别为 0. 805、0. 912、0. 787 和 0. 673, 标准误（s）分别为0.050、0.053、0. 041和0. 028, 95%置信区间分别为 0. 731 ?0.892、0. 877?0. 964、0. 693—0. 835 和 0. 612?0. 763。 结论PCT不仅可以作为早期诊断细菌性感染的特异性指标，还可用于 细菌性感染与病毒性感染的鉴别诊断，同时动态监测PCT水平变化对治疗 细菌性感染也有一定的指导作用，值得临床推广应用。 【关键词】降钙素原；感染性疾病；细菌感染；病毒感染 [Abstract】 Objective To investigate the clinical value of detection of scrum procalcitonin ( PCT ) in early diagnosis of bacterial infection. Methods A total of 347 patients with infectious diseases were selected as research objects, and divided into bacterial infection group (n=212) and viral infection group (n=135)? Bacterial culture and identification wore carried out by ATB bacterial identification and analysis system.The serum levels of PCT and C~reactive protein (CRP ) were measured by latex enhanced immune scattering turbidimetry on Roche Cobas E411 automated elec trochem 订 uminescence imm uno assay ins trument ? In add ition, SPSS 13 statistical software was adopted to compare and analyze the test results of each group. Results In the bacterial infection group, the positive rate of PCT test was 86. 79%, which was higher than that (6. 67%) of viral infection group ( x 2=214. 519, P〈0? 001), and compared with bacterial culture results, difference was not statistically significant ( x 2=0. 125, P=0. 724)? ROC curve analysis results also showed that the area of ROC curve of CRP, PCT, WBC and ESR were respectively 0. 805, 0. 912, 0. 787 and 0. 673, standard error (s) were respectively 0. 050, 0.053 , 0.041 and 0.028 , and 95% confidence intervals were respectively 0. 731~0. 892, 0. 877~0. 964, 0. 693?0. 835 and 0. 612~