CAJ | 학술논문

目的：探讨降钙素原在重症监护室（ICU）血流感染患者鉴别菌种及预后判断中的作用。方法选择ICU 血流感染患者共69例，检测所有研究对象血清降钙素原（PCT）水平，进行血培养、菌种鉴定，并随访30 d 患者预后，评价 PCT 在 ICU 血流感染患者早期鉴别菌种与预后判断中的作用。结果革兰阴性菌感染患者的 PCT 水平显著高于革兰阳性菌和真菌感染的患者，真菌感染的患者 PCT 水平显著高于革兰阳性菌感染患者（均 P ＜0．01）。在区分革兰阳性菌与革兰阴性菌和革兰阴性菌与真菌时计算 PCT 的界值分别为1．94 ng/mL 和4．35 ng/mL，能获得最好的灵敏度和特异性与 ROC 曲线下面积，分别为0．87和0．59。革兰阴性菌和真菌感染的死亡患者血清 PCT 水平显著高于存活患者（P ＝0．003、0．013），而在革兰阳性菌感染的患者中差异无统计学意义（P ＝0．473）。结论PCT 在 ICU 血流感染患者鉴别菌种和预后判断中具有较好的预测作用，值得临床借鉴。
목적：탐토강개소원재중증감호실（ICU）혈류감염환자감별균충급예후판단중적작용。방법선택ICU 혈류감염환자공69례，검측소유연구대상혈청강개소원（PCT）수평，진행혈배양、균충감정，병수방30 d 환자예후，평개 PCT 재 ICU 혈류감염환자조기감별균충여예후판단중적작용。결과혁란음성균감염환자적 PCT 수평현저고우혁란양성균화진균감염적환자，진균감염적환자 PCT 수평현저고우혁란양성균감염환자（균 P ＜0．01）。재구분혁란양성균여혁란음성균화혁란음성균여진균시계산 PCT 적계치분별위1．94 ng/mL 화4．35 ng/mL，능획득최호적령민도화특이성여 ROC 곡선하면적，분별위0．87화0．59。혁란음성균화진균감염적사망환자혈청 PCT 수평현저고우존활환자（P ＝0．003、0．013），이재혁란양성균감염적환자중차이무통계학의의（P ＝0．473）。결론PCT 재 ICU 혈류감염환자감별균충화예후판단중구유교호적예측작용，치득림상차감。
Objective To investigate the roles of procalcitonin(PCT)in species identification and prognosis in patients with bloodstream infections in intensive care unit (ICU).Methods 69 patients with bloodstream infections in ICU were collected.Test the levels of Serum PCT,blood culture and strain identification levels blood cultures. Follow-up of 30 d ,Identification of bacteria and evaluation of prognosis were undertaken with PCT in patients with bloodstream infections in the ICU.Results PCT levels in patients with G- bacterial infections were significantly higher than that with G+ bacterial and fungi infections.PCT levels in patients with fungi infections were significant-ly higher than G+ bacteria-infected patients (P <0.01).Boundary value of PCT in distinguishing G+ bacteria and G- bacteria,G- bacteria and fungi were 1.94ng/mL and 4.35 ng/mL,which could get the best specificity,sensi-tivity and the area under the ROC curve,0.87 and 0.59.Serum PCT levels in the dead patients with G- bacterial and fungi infections were significantly higher than survival patients (P = 0.003 and 0.013),while no significant difference(P =0.473)in patients with G+ bacterial infections.Conclusion PCT has a better predictor of species i-dentification and prognosis in ICU patients with bloodstream infections,which is worthy of clinical reference.