摘要
目的探讨血清降钙素原(PCT)预测血培养阳性的临床应用价值。方法采用回顾性分析研究,以2012年12月-2014年12月同时进行PCT和血培养检测1 164例患者为研究对象,根据血培养结果分为阳性组和阴性组,比较两组间PCT、C-反应蛋白(CRP)水平等实验室指标的差异。结果血培养阳性组PCT、CRP明显高于血培养阴性组,差异有统计学意义(P<0.001);单因素logistics回归分析显示,PCT、CRP及体温均为菌血症预测因子,差异有统计学意义(P<0.001),多因素logistics回归分析显示,校正年龄、抗菌药物预处理因素后,年龄、PCT、CRP是预测血培养阳性的独立预测因子;血清PCT预测血培养阳性ROC曲线下面积为0.800,当截断点为PCT>0.05ng/ml时,PCT预测血培养阳性的敏感性高达96%,与其他临床实验室指标相比,PCT预测血培养阳性诊断价值最高;在PCT<0.05ng/ml时,菌血症发生风险低,而PCT>0.5ng/ml时,菌血症发生风险高,有利于早期诊断和病情检查,合理使用抗菌药物。结论 PCT预测血培养阳性是非常有意义的,比CRP、WBC计数和其他临床实验室指标均要好,而且血清PCT检测能够减少患者的血培养数量及医疗成本,实施更合理的卫生保健资源分配。
OBJECTIVE To discuss the clinical significance of serum procalcitonin in predicting blood culture positive.METHODS A total of 1164 patients undergoing PCT and blood cultures from Dec.2012 to Dec.2014 were selected as research objects by retrospective analysis.The patients were classified into blood culture positive group and blood culture negative group,the differences of PCT and C-reactive protein（CRP）concentration in two groups were analyzed comparatively.RESULTS The PCT and CRP in blood culture positive group were higher than blood culture negative group,and the difference was significant（P〈0.001）.In single factor logistics regression analysis,PCT,CRP and temperature were all the independent predictors for bacteremia,and the difference was significant（P〈0.001）.In multivariate regression analysis,after revising age,pretreatment of antimicrobial drugs,age,PCT and CRP were the independent predictors for blood culture positive.The area of using PCT predicting blood culture positive was 0.800 under the receiver operating characteristics curve.When the cut-off point was PCT〉0.05ng/ml,the sensitivity to predict positive blood cultures was 96%.Compared with those of other clinical laboratory indexes,PCT predict blood culture positive had the highest diagnostic value.When PCT〈0.05ng/mL,there was a very low risk to have bacteremia,but when PCT〉0.5ng/mL,bacteremia had a high risk,which maight help to early diagnosis and test,so as to use right antibacterial agents.CONCLUSIONPCT predicts positive blood culture is very significant,which is better than CRP,white blood cells（WBC）count and other clinical laboratory indexes.PCT measurement has the potential to reduce the number of blood cultures and cost in patients and to implement a more targeted allocation of limited health-care resources.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2016年第16期3622-3624,3627,共4页
Chinese Journal of Nosocomiology
基金
浙江省科技厅基金资助项目(2016C33SA800035)
关键词
降钙素原
血培养阳性
C-反应蛋白
Procalcitonin
Positive blood culture
C-reactive protein
