中华急诊医学杂志
中華急診醫學雜誌
중화급진의학잡지
CHINESE JOURNAL OF EMERGENCY MEDICINE
2013年
10期
1136-1141
,共6页
降钙素原%宿主反应%细菌培养%真菌%脓毒症%预后%Spearman相关分析%ROC曲线
降鈣素原%宿主反應%細菌培養%真菌%膿毒癥%預後%Spearman相關分析%ROC麯線
강개소원%숙주반응%세균배양%진균%농독증%예후%Spearman상관분석%ROC곡선
Procalcitonin%Host reaction%Bacterial culture%Fungi%Sepsis%Prognosis%Spearman correlation analysis%ROC curve
目的 探讨降钙素原(PCT)质量浓度对脓毒症患者短期预后的预测价值以及与病原学感染证据之间的相关性.方法 回顾性分析2011年10月至2012年9月武汉大学人民医院急诊监护室、重症监护室、呼吸监护室收治的脓毒症患者278例,其中193例患者病原学结果阳性.比较不同病原感染组之间PCT质量浓度,入院首次PCT质量浓度与入院7d病死率的相关性分析,PCT质量浓度与细菌学培养结果之间的相关性分析.结果 Spearman相关分析结果显示,细菌感染的脓毒症患者PCT水平显著高于非细菌感染的脓毒症患者(P=0.001).细菌感染的脓毒症患者首次PCT质量浓度与入院7d预后存在显著正相关性(r=0.277,P=0.004).不同水平的PCT质量浓度与细菌学培养结果之间的相关性不同.PCT水平较高的患者(≥2 ng/ml)更易获得病原学阳性结果.结论 PCT对诊断细菌感染导致脓毒症具有高度特异性和灵敏性.细菌感染的脓毒症患者首次PCT质量浓度与入院7d预后存在显著正相关.PCT质量浓度反应的是宿主对细菌感染导致全身炎症反应的严重程度,而病原学证据直接反应致病源,两者反应了细菌感染的两个方面,相辅相成,但不可相互替代.
目的 探討降鈣素原(PCT)質量濃度對膿毒癥患者短期預後的預測價值以及與病原學感染證據之間的相關性.方法 迴顧性分析2011年10月至2012年9月武漢大學人民醫院急診鑑護室、重癥鑑護室、呼吸鑑護室收治的膿毒癥患者278例,其中193例患者病原學結果暘性.比較不同病原感染組之間PCT質量濃度,入院首次PCT質量濃度與入院7d病死率的相關性分析,PCT質量濃度與細菌學培養結果之間的相關性分析.結果 Spearman相關分析結果顯示,細菌感染的膿毒癥患者PCT水平顯著高于非細菌感染的膿毒癥患者(P=0.001).細菌感染的膿毒癥患者首次PCT質量濃度與入院7d預後存在顯著正相關性(r=0.277,P=0.004).不同水平的PCT質量濃度與細菌學培養結果之間的相關性不同.PCT水平較高的患者(≥2 ng/ml)更易穫得病原學暘性結果.結論 PCT對診斷細菌感染導緻膿毒癥具有高度特異性和靈敏性.細菌感染的膿毒癥患者首次PCT質量濃度與入院7d預後存在顯著正相關.PCT質量濃度反應的是宿主對細菌感染導緻全身炎癥反應的嚴重程度,而病原學證據直接反應緻病源,兩者反應瞭細菌感染的兩箇方麵,相輔相成,但不可相互替代.
목적 탐토강개소원(PCT)질량농도대농독증환자단기예후적예측개치이급여병원학감염증거지간적상관성.방법 회고성분석2011년10월지2012년9월무한대학인민의원급진감호실、중증감호실、호흡감호실수치적농독증환자278례,기중193례환자병원학결과양성.비교불동병원감염조지간PCT질량농도,입원수차PCT질량농도여입원7d병사솔적상관성분석,PCT질량농도여세균학배양결과지간적상관성분석.결과 Spearman상관분석결과현시,세균감염적농독증환자PCT수평현저고우비세균감염적농독증환자(P=0.001).세균감염적농독증환자수차PCT질량농도여입원7d예후존재현저정상관성(r=0.277,P=0.004).불동수평적PCT질량농도여세균학배양결과지간적상관성불동.PCT수평교고적환자(≥2 ng/ml)경역획득병원학양성결과.결론 PCT대진단세균감염도치농독증구유고도특이성화령민성.세균감염적농독증환자수차PCT질량농도여입원7d예후존재현저정상관.PCT질량농도반응적시숙주대세균감염도치전신염증반응적엄중정도,이병원학증거직접반응치병원,량자반응료세균감염적량개방면,상보상성,단불가상호체대.
Objective To investigate the diagnostic and predict vaIue of procalcitonin (PCT) in ICU patients with sepsis and the correlation between PCT concentration and positive results of bacterial culture.Methods A total of 278 patients with sepsis were admitted into emergency ICU,general ICU and respiratory ICU from October 2011 to September 2012.Of them,193 patients had definite microbial infection evidence.Serum PCT levels among groups of different pathogens were compared.The analysis of correlation between the PCT concentration of the first assay was got after admission and short-term prognosis was evaluated.The correlation between PCT level and positive results of bacterial culture was also evaluated.Results Spearman correlation analysis showed that serum PCT levels of bacterial infections in patients with sepsis were significantly higher than those of the non-bacterial infections in patients with sepsis (P =0.001).And there was a positive correlation between the PCT concentration of the first specimen after admission and 7-day in-hospital mortality in patients with sepsis due to bacterial infections (r =0.277,P =0.004).The patients with PCT levels greater than 2 ng/ml had high vulnerability to bacterial infection Conclusions The PCT concentration of the first assay after admission was positively correlated to 7-day mortality in ICU patients with sepsis due to bacterial infections.The serum PCT concentration indicated the severity of host response to the bacterial infection.And etiological evidence directly showed pathogenic factors.Both of PCT and etiological evidence related to bacterial infection,reflected different aspects of bacterial infection.
