摘要
目的探讨血浆降钙素原（PCT）在革兰阴性菌与革兰阳性菌所致肺炎中的鉴别诊断价值，指导临床经验性用药时抗菌药物的选择。方法选择2014年1月-2015年3月首都医科大学附属北京佑安医院及北京市密云县医院收治肺炎患者124例，根据痰细菌培养鉴定结果分为革兰阴性菌感染组（44例）、革兰阳性菌感染组（40例）及非细菌性感染组（40例），分别进行PCT和c反应蛋白（CRP）定量水平检测，对检测结果进行统计学分析，并用受试者工作特征曲线（ROC曲线）判断二者在革兰阴性菌与革兰阳性菌肺炎中的诊断价值。结果PCT浓度在革兰阴性菌感染组与非细菌感染组间差异有统计学意义（P〈0．05），革兰阳性菌感染组与非细菌感染组间差异无统计学意义（P〉0．05），革兰阴性菌、革兰阳性菌感染组间差异有统计学意义（P〈0．05）；CRP浓度在革兰阴性菌、革兰阳性菌组间差异无统计学意义（P〉0．05）；ROC曲线分析PCT的曲线下面积（AUC）为0．772，95％C10．670-0．874，P〈O．05：CRP的曲线下面积为0．531，95％C10．406-0．655，P=0．629。结论PCT和ClIP均可作为感染的特异性诊断指标，PCT在革兰阴性菌与革兰阳性菌所致肺炎的鉴别诊断中具有重要的价值；PCT对革兰阴性菌感染肺炎的早期诊断及鉴别诊断价值高于CRP。
Objective To evaluate the diagnosis value of serum proealeitonin （PCT） levels for differentiating Gram-pos- itive and Gram-negative bacteria induced pneumonia. Methods t24 cases of patients with pneumonia treated in Beijing You＇an Hospital, Capital Medical University or Miyun County Hospital from January 2014 to March 2015 were selected. According to sputum bacterial culture identification results, patients were divided into the Gram-negative bacteria in- fection group （44 eases）, Gram-positive bacteria infection group （40 cases） and non-infection group （40 cases）. The concentrations of PCT and CRP in peripheral blood were detected and analyzed. The ROC curve was used to evaluate the diagnostic value of the serum PCT and CRP. Results There was significantly difference in the PCT levels between Gram-negative bacteria infection group and non-infection group （P 〈 0.05）; there was no significantly difference in the PCT levels between Gram-positive bacteria infection group and non-infection group （P 〉 0.05）; there was significantly difference in the PCT levels between Gram-negative bacteria infection group and Gram-positive bacteria infection group （P 〈 0.05）. There was no significantly difference in the serum CRP levels between Gram-negative and Gram- positive group （P 〉 0.05）. Area under the curve （AUC） adopted from ROCs for distinguishing Gram-negative bacteria and Gram-positive bacteria induced pneumonia turned out respectively as PCT was 0.772, 95%CI 0.670-0.874, P 〈 0.05,CRP was 0.531 95%CI 0.406-0.655, P=0.629. Conclusion PCT and CRP can be used as the specificity of diagno- sis index of infection. PCT has significant value for differentiating Gram-positive and Gram-negative bacteria inducedpneumonia. Serum PCT concentration is more valuable than serum CRP for early diagnosis and differentiating Gram-negative bacteria induced pneumonia.
出处
《中国医药导报》
CAS
2015年第36期13-16,共4页
China Medical Herald
基金
国家十二五科技重大专项(2012ZX10005010)
关键词
降钙素原
C反应蛋白
肺炎
革兰阴性菌
革兰阳性菌
Procalcitonin
C-reactive protein
Pneu-monia
Gram-positive bacteria
Gram-negative bacteria
