CAJ | 학술논문

目的：观察不同真菌感染降钙素原的差异性，并对其与疾病预后的相关性进行分析。方法选取2012年6月－2013年6月于IC U就诊的危重病患者54例，根据危险评分分组，非危重组24例、危重组25例、极危重组5例；研究不同感染部位血清降钙素原水平、不同菌株感染血清降钙素原水平以及降钙素原与疾病预后的相关性。结果54例真菌感染患者中肺部感染26例占48．15％、消化道感染12例占22．21％、泌尿道感染9例占16．67％、血流感染9例占12．96％；不同感染部位血清降钙素原水平具有一定差异性，其中血清降钙素原水平较其他部位明显偏高，差异有统计学意义（ P＜0．05）；共培养出病原菌86株，其中白色假丝酵母菌占55．81％，热带假丝酵母菌占37．21％，克柔假丝酵母菌占6．98％，降钙素原水平差异无统计学意义；随着危重程度的不断升高，降钙素原水平逐渐增高，组间差异有统计学意义（P＜0．05），PCT与危重评分呈正相关（P＜0．05）。结论降钙素原对真菌感染的诊断有重大意义，但不同菌株间差异无显著性，其水平与疾病危重程度密切相关。
목적：관찰불동진균감염강개소원적차이성，병대기여질병예후적상관성진행분석。방법선취2012년6월－2013년6월우IC U취진적위중병환자54례，근거위험평분분조，비위중조24례、위중조25례、겁위중조5례；연구불동감염부위혈청강개소원수평、불동균주감염혈청강개소원수평이급강개소원여질병예후적상관성。결과54례진균감염환자중폐부감염26례점48．15％、소화도감염12례점22．21％、비뇨도감염9례점16．67％、혈류감염9례점12．96％；불동감염부위혈청강개소원수평구유일정차이성，기중혈청강개소원수평교기타부위명현편고，차이유통계학의의（ P＜0．05）；공배양출병원균86주，기중백색가사효모균점55．81％，열대가사효모균점37．21％，극유가사효모균점6．98％，강개소원수평차이무통계학의의；수착위중정도적불단승고，강개소원수평축점증고，조간차이유통계학의의（P＜0．05），PCT여위중평분정정상관（P＜0．05）。결론강개소원대진균감염적진단유중대의의，단불동균주간차이무현저성，기수평여질병위중정도밀절상관。
OBJECTIVE To observe the difference in the procalcitonin level of the patients with different fungal in‐fections and explore its relationship with the prognosis of disease .METHODS A total of 54 critically ill patients who were treated in the ICU from Jun 2012 to Jun 2013 were enrolled in the study and divided into the non‐critical‐ly ill group with 24 cases ,the critically ill group with 25 cases ,and the extremely critically ill group with 5 cases according to the score of risk .The levels of procalcitonin of the patients with different sites of infections ,the levels of procalcitonin of the patients with infections due to different species of pathogens ,and the relationship between the level of procalcitonin and the prognosis of disease were observed .RESULTS The pulmonary infections oc‐curred in 26 (48 .15% ) of 54 patients w ith fungal infections ,of w hom 12 (22 .21% ) cases had the gastroin‐testinal tract infections ,9 (16 .67% ) cases had the urinary tract infections ,and 9 (12 .96% ) cases had the bloodstream infections .T he level of procalcitonin vaired in the patients w ith different sites of infections ,and the level of serum procalcitonin was higher ,there was significant difference (P< 0 .05) .Totally 86 strains of pathogens have been isolated ,of which 55 .81% were the Candida albicans ,37 .21% were the Candida tropicalis ,and 6 .98% were the Candida krusei ,there was no significant difference in the level of procalcito‐nin .The level of procalcitonin was significantly elevated with the increase of severity(P< 0 .05);PCT was positively correlated with the score of severity (P< 0 .05) .CONCLUSION The level of procalcitonin has great significance in diagnosis of fungal infections and varies significantly in the different species of strains ,and it is closely related to the severity of disease .