现代检验医学杂志
現代檢驗醫學雜誌
현대검험의학잡지
JOURNAL OF MODERN LABORATORY MEDICINE
2015年
2期
77-79,83
,共4页
降钙素原%革兰阴性菌%菌血症
降鈣素原%革蘭陰性菌%菌血癥
강개소원%혁란음성균%균혈증
procalcitonin%Gram-negative bacteria%bacteremia
目的：评估血清降钙素原（PCT）水平预示革兰阴性（GN）菌血症的价值。方法选取2013年1月～12月同时进行了血液培养和 PCT 测定的病例，排除污染生长情况，纳入研究的血液培养阳性499例，依据培养鉴定结果将血液培养阳性病例分组：GN 菌血症组314例，其中，男性159例，女性155例；革兰阳性（GP）菌血症组185例，男性107例，女性78例。对研究对象的血清 PCT 结果进行统计学处理。结果GN 菌血症组 PCT 水平（中位数＝5.16，0.02～450.10 ng／ml）明显高于 GP 菌血症组（中位数＝0.38，0.02～44.70 ng／ml）（P ＝0.000）；随着 PCT 水平的升高，GN 菌血症所占比例越来越高，当 PCT≥45.0 ng／ml，GN 菌血症的比例占到100％；以6.00 ng／ml 为判断值，PCT 诊断 GN 菌血症的灵敏度、特异度、阳性预示值和阴性预示值分别为49.4％，85.2％，85.6％和50.0％，ROC 曲线下面积（AUC）为0.714，95％可信区间（CI）为0.672～0.753，SE＝0.0229，P ＜0.0001。结论PCT 是预示 GN 菌血症早期的和可靠的标记物，可以早期地指导抗生素治疗的药物选择。
目的：評估血清降鈣素原（PCT）水平預示革蘭陰性（GN）菌血癥的價值。方法選取2013年1月～12月同時進行瞭血液培養和 PCT 測定的病例，排除汙染生長情況，納入研究的血液培養暘性499例，依據培養鑒定結果將血液培養暘性病例分組：GN 菌血癥組314例，其中，男性159例，女性155例；革蘭暘性（GP）菌血癥組185例，男性107例，女性78例。對研究對象的血清 PCT 結果進行統計學處理。結果GN 菌血癥組 PCT 水平（中位數＝5.16，0.02～450.10 ng／ml）明顯高于 GP 菌血癥組（中位數＝0.38，0.02～44.70 ng／ml）（P ＝0.000）；隨著 PCT 水平的升高，GN 菌血癥所佔比例越來越高，噹 PCT≥45.0 ng／ml，GN 菌血癥的比例佔到100％；以6.00 ng／ml 為判斷值，PCT 診斷 GN 菌血癥的靈敏度、特異度、暘性預示值和陰性預示值分彆為49.4％，85.2％，85.6％和50.0％，ROC 麯線下麵積（AUC）為0.714，95％可信區間（CI）為0.672～0.753，SE＝0.0229，P ＜0.0001。結論PCT 是預示 GN 菌血癥早期的和可靠的標記物，可以早期地指導抗生素治療的藥物選擇。
목적：평고혈청강개소원（PCT）수평예시혁란음성（GN）균혈증적개치。방법선취2013년1월～12월동시진행료혈액배양화 PCT 측정적병례，배제오염생장정황，납입연구적혈액배양양성499례，의거배양감정결과장혈액배양양성병례분조：GN 균혈증조314례，기중，남성159례，녀성155례；혁란양성（GP）균혈증조185례，남성107례，녀성78례。대연구대상적혈청 PCT 결과진행통계학처리。결과GN 균혈증조 PCT 수평（중위수＝5.16，0.02～450.10 ng／ml）명현고우 GP 균혈증조（중위수＝0.38，0.02～44.70 ng／ml）（P ＝0.000）；수착 PCT 수평적승고，GN 균혈증소점비례월래월고，당 PCT≥45.0 ng／ml，GN 균혈증적비례점도100％；이6.00 ng／ml 위판단치，PCT 진단 GN 균혈증적령민도、특이도、양성예시치화음성예시치분별위49.4％，85.2％，85.6％화50.0％，ROC 곡선하면적（AUC）위0.714，95％가신구간（CI）위0.672～0.753，SE＝0.0229，P ＜0.0001。결론PCT 시예시 GN 균혈증조기적화가고적표기물，가이조기지지도항생소치료적약물선택。
Objective To evaluate the values of procalcitonin (PCT)level in serum for predicting Gram-negative bacteremia (GNB).Methods Among 499 candidates for study entry,314 were GN bacteraemia,and 185 were Gram-positive bacterae-mia (GPB).The serum PCT level were measured in 499 candidates.Results PCT levels were found to be markedly higher in patients with GNB (median=5.16,0.02~450.10 ng/ml)than in those with GPB (median=0.38,0.02~44.70ng/ml) (P =0.000).The percentage of GNB were increased along with PCT level.The proportion of GNB was 100% when PCT ≥45.0 ng/ml.For prediction of GNB a PCT level of 6.00 ng/ml had a sensitivity of 49.4% and specificity of 85.2% and posi-tive predictive value of 85.6% and negative predictive value of 50.0%,respectively.The area under the receiver operating characteristic curve for discriminating GNB and GPB was 0.714,confidence interval of 95% was 0.672 ~ 0.753,SE =0.0229,P <0.0001.Conclusion PCT is an early and reliable indicator for predicting GNB.
