摘要
目的探究血前清蛋白、纤维蛋白原比值(PA/FIB)、血小板计数(PLT)联合降钙素原(PCT)鉴别血流感染不同感染细菌类型的价值。方法本研究对2021年2月至2022年2月濮阳市安阳地区医院82例经过血培养为阳性的血流感染患者进行了回顾性研究。根据细菌类型将其分成革兰氏阴性菌组(GNB-BSI组,38例)和革兰氏阳性菌组(GPB-BSI组,44例),另取41例血培养为阴性的住院患者作为对照组。比较各组PA/FIB、PLT和PCT水平,采用受试者工作特征(ROC)曲线分析PA/FIB、PLT和PCT鉴别血流感染不同感染细菌类型的价值。结果GNB-BSI组与GPB-BSI组PA/FIB、PLT水平均低于对照组,GNB-BSI组与GPB-BSI组PCT水平均高于对照组(P<0.05);GPB-BSI组PA/FIB、PCT水平低于GNB-BSI组,PLT水平高于GNB-BSI组(P<0.05)。PCT约登指数最大时对应的cut-off为9.86 ng/mL,曲线下面积(AUC)为0.817,鉴别的敏感度为81.58%,特异性为81.82%。PA/FIB鉴别的敏感度与特异性分别为68.42%与88.64%。PLT鉴别的敏感度为86.36%,特异性为60.53%。PA/FIB、PLT与PCT联合鉴别的AUC为0.939,敏感度为97.37%,特异性为84.09%。结论GPB-BSI血流感染患者PA/FIB、PCT较GNB-BSI感染低,PLT水平更高,三者在鉴别GNB-BSI与GPB-BSI时均有较高的准确度与敏感度,血PA/FIB比值、PLT与PCT联合鉴别血流感染不同的细菌类型可提高敏感度与特异性,具有较高的应用价值,可为临床提供一定的理论依据。
【Objective】To explore the value of serum prealbumin to fibrinogen ratio(PA/FIB),platelet count(PLT)combined with procalcitonin(PCT)in identifying different bacterial types of bloodstream infections.【Methods】Eighty-two patients with bloodstream infections and positive blood culture were retrospectively studied,and they were divided into 38 cases of Gramnegative bacteria(GNB-BSI group)and 44 cases of Gram-positive bacteria(GPB-BSI group)according to bacterial types.Another 41 inpatients with negative blood culture were selected as control group.The levels of PA/FIB,PLT and PCT in each group were compared,and receiver operating characteristic(ROC)curve was used to analyze the value of PA/FIB,PLT and PCT in differentiating different bacterial types of bloodstream infections.【Results】The levels of PA/FIB and PLT in GNB-BSI group and GPB-BSI group were lower than those in control group while the PCT level was higher than that in control group(P<0.05).Compared with GNB-BSI group,PA/FIB and PCT were lower while PLT was higher in GPB-BSI group(P<0.05).When the Youden index of PCT was the largest,the corresponding cut-off,area under the curve(AUC),sensitivity and specificity of differentiating GNB-BSI and GPB-BSI were 9.86 ng/mL,0.817,81.58%and 81.82%.The sensitivity and specificity were 68.42%and 88.64%of PA/FIB identification and were 86.36%and 60.53%of PLT identification respectively.The AUC,sensitivity and specificity of the combination of PA/FIB,PLT and PCT were 0.939,97.37%and 84.09%.【Conclusion】PA/FIB and PCT in patients with GPB-BSI bloodstream infection are lower than those in patients with GNB-BSI infection while the level of PLT is higher.The three indicators have high accuracy and sensitivity in differentiating GNB-BSI and GPB-BSI.The combination of blood PA/FIB ratio,PLT and PCT to identify different bacterial types of bloodstream infections can enhance the sensitivity and specificity,and has high application value and can provide a certain theoretical basis for clinical practice.
作者
耿东方
GENG Dongfang(Clinical Laboratory,Anyang District Hospital,Anyang,Henan 455000,China)
出处
《中国医学工程》
2023年第8期59-62,共4页
China Medical Engineering
