感染检测指标降钙素原PCT实用ppt课件.pptxVIP

感染检测新指标降钙素原PCT 1 感染检测新指标降钙素 原PCT 2 → 增加临床细菌感染诊断的准确性 → 更早作出适当的治疗决定 3 如何克服这些困难? 有效指标协助临床判断 2 降钙素原的临床意义 3 降钙素原指导抗生素使用的研究进展 目录 降钙素原的一般概况 4 一、降钙素原的一般概况 5 结构 来源 代谢 检测 降钙素原概况 6 Lanct. 1993Feb27;341(6844)515-8. High serumprocalctonin concentrations in patients with sepsis and infection. AssotM GendelD CarsnH Famond Gilbad Bhunc Depatenertde Bibgie Ciniue,hstht Gustave-Russy,Vieiu, Frane. Abstract High conemtatons of calcitonin-like mmunoreactity have been found in the blood ofpalents wth various etrathyoid diseases.By means ofamonoclonalimmunoradiomeric assayfor calctonin precursors,we have mieasued serum concentatons ofprocalctoninin paients with anous bactenal amd wialintectons.79chiden(newoom to age 12yeas)in hospital wth suspected imections were imestigated prospectie.19 patens with severe bacteralinecions had ver high serumconcentatons ofprocalctonin atdiagnosis (ange 6-53ngml)in comparson wth 21 children found to hare no signs ofinfection(baseline concentatons0.1ngml),Senum procalctoninvalues cecreased rapidly dung antbioictherapy. 11 palentswth perpheral bacteralcolonisalion orlocalinfections withoutimiasive sepsis and 18 (86%)0121 paients with wiralinecions had conemtadlions wihin orslghty above the nomalrange(1.1 1.5ngml),Among9 severey bumed patents studied in an intensiwve care unt,the postaumatc couse ofprocalctonin comentations (iange 0.1-120ngml)was loseyrelated to inecfous complicatons amd acute sepic episoues.Comcentatons of mature calctonin were nomalin al sutjects,whatever procalctonin concentraions were found.Concemtadlions ofa substance immunologicalyidentcal oprocalctonin are raised duing sepic condtions. Seum concentatons seemto be corelated wth the severty ofmicrobialivasion. 1993年，法国学者( Assicot M ) 第一个发现 PCT在严重细菌感染时显 著升高，而在不是细菌感 染时不升高或轻微升高， 从而可以在临床上鉴别细 菌感染和非细菌感染 PCT 的发现 7 降钙素原(PCT)是无激素活性的降钙素前体(116 AA;13 KD), 是11号染色体上(11p15,4) 降钙素 I 基 因 ( CALC-1) 的表达产物 1 A