检验医学
檢驗醫學
검험의학
Laboratory Medicine
2015年
9期
881-885
,共5页
慕月晶%王伟佳%徐胜男%阚丽娟%黄燕华%欧阳能良%徐全中%严海忠%张秀明
慕月晶%王偉佳%徐勝男%闞麗娟%黃燕華%歐暘能良%徐全中%嚴海忠%張秀明
모월정%왕위가%서성남%감려연%황연화%구양능량%서전중%엄해충%장수명
降钙素原%感染再发%白细胞%白细胞介素6
降鈣素原%感染再髮%白細胞%白細胞介素6
강개소원%감염재발%백세포%백세포개소6
Procalcitonin%Recurrent infection%White blood cell%Interleukin 6
目的:探讨血清降钙素原( PCT )动态水平对诊断感染再发的临床应用价值,并对感染再发患者的PCT诊断界值进行研究。方法收集中山大学附属中山医院细菌感染患者150例,动态监测其血清PCT水平,其中感染再发患者100例,治疗有效患者50例。观察细菌感染再发患者PCT回升水平及与其同期治疗有效患者PCT水平的差异情况。同时收集健康对照者60名,分析感染再发患者PCT水平回升拐点与健康成人PCT水平的差异。采用受试者工作特征(ROC)曲线分析PCT、白细胞(WBC)、白细胞介素6(IL-6)检测对感染再发的诊断性能,并初步设定PCT诊断感染再发的界值。结果 PCT水平动态监测结果显示感染再发与治疗有效呈不同的变化趋势,其中感染再发患者PCT水平出现回升现象,且明显高于治疗有效患者(P<0.05);感染再发患者PCT水平回升拐点仍高于健康人(P<0.05)。 ROC曲线分析显示,PCT对于感染再发诊断的ROC曲线下面积为83.5%,其性能最佳[敏感性89.0%、特异性83.0%、阳性预测值84.0%和阴性预测值88.3%]处的界值为2.29 ng/mL,而WBC和IL-6诊断感染再发的ROC曲线下面积分别为55.1%和61.0%。结论动态监测血清PCT水平对诊断及鉴别诊断细菌引起的感染再发具有重要的临床应用价值。
目的:探討血清降鈣素原( PCT )動態水平對診斷感染再髮的臨床應用價值,併對感染再髮患者的PCT診斷界值進行研究。方法收集中山大學附屬中山醫院細菌感染患者150例,動態鑑測其血清PCT水平,其中感染再髮患者100例,治療有效患者50例。觀察細菌感染再髮患者PCT迴升水平及與其同期治療有效患者PCT水平的差異情況。同時收集健康對照者60名,分析感染再髮患者PCT水平迴升枴點與健康成人PCT水平的差異。採用受試者工作特徵(ROC)麯線分析PCT、白細胞(WBC)、白細胞介素6(IL-6)檢測對感染再髮的診斷性能,併初步設定PCT診斷感染再髮的界值。結果 PCT水平動態鑑測結果顯示感染再髮與治療有效呈不同的變化趨勢,其中感染再髮患者PCT水平齣現迴升現象,且明顯高于治療有效患者(P<0.05);感染再髮患者PCT水平迴升枴點仍高于健康人(P<0.05)。 ROC麯線分析顯示,PCT對于感染再髮診斷的ROC麯線下麵積為83.5%,其性能最佳[敏感性89.0%、特異性83.0%、暘性預測值84.0%和陰性預測值88.3%]處的界值為2.29 ng/mL,而WBC和IL-6診斷感染再髮的ROC麯線下麵積分彆為55.1%和61.0%。結論動態鑑測血清PCT水平對診斷及鑒彆診斷細菌引起的感染再髮具有重要的臨床應用價值。
목적:탐토혈청강개소원( PCT )동태수평대진단감염재발적림상응용개치,병대감염재발환자적PCT진단계치진행연구。방법수집중산대학부속중산의원세균감염환자150례,동태감측기혈청PCT수평,기중감염재발환자100례,치료유효환자50례。관찰세균감염재발환자PCT회승수평급여기동기치료유효환자PCT수평적차이정황。동시수집건강대조자60명,분석감염재발환자PCT수평회승괴점여건강성인PCT수평적차이。채용수시자공작특정(ROC)곡선분석PCT、백세포(WBC)、백세포개소6(IL-6)검측대감염재발적진단성능,병초보설정PCT진단감염재발적계치。결과 PCT수평동태감측결과현시감염재발여치료유효정불동적변화추세,기중감염재발환자PCT수평출현회승현상,차명현고우치료유효환자(P<0.05);감염재발환자PCT수평회승괴점잉고우건강인(P<0.05)。 ROC곡선분석현시,PCT대우감염재발진단적ROC곡선하면적위83.5%,기성능최가[민감성89.0%、특이성83.0%、양성예측치84.0%화음성예측치88.3%]처적계치위2.29 ng/mL,이WBC화IL-6진단감염재발적ROC곡선하면적분별위55.1%화61.0%。결론동태감측혈청PCT수평대진단급감별진단세균인기적감염재발구유중요적림상응용개치。
Objective To investigate the clinical application significance of serum procalcitonin ( PCT ) level dynamic monitoring for diagnosing recurrent infection, and to investigate the PCT cut-off value for recurrent infection. Methods The retrospective study enrolled 150 patients with bacterial infection in Zhongshan Hospital, Sun Yat-sen University, and the change of serum PCT level was monitored dynamically.Among them,100 patients suffered from recurrent infection, while the other 50 patients acquired effective treatment.The PCT levels of recurrent infection group and effective treatment group in the same period were observed, and the difference between them was analyzed.A total of 60 blood samples from healthy subjects were also collected, and the difference between recurrent turning points of PCT and PCT levels of healthy subjects was analyzed.The diagnostic performance of PCT, white blood cell ( WBC ) and interleukin 6 (IL-6) for recurrent infection with receiver operating characteristic (ROC) curve was evaluated, and a primary diagnostic cut-off value of PCT was established for recurrent infection.Results In recurrent infection group and effective treatment group, the serum PCT levels showed different trends.The recurrent infection group showed an obvious rebound, and the level was higher than that in effective treatment group (P<0.05).The rebound turning points of serum PCT level in recurrent infection group were still higher than those in healthy subjects( P<0.05) .The diagnostic significance of PCT for recurrent infection was confirmed by ROC curve analysis, and the area under the ROC curve for PCT was 83.5%.The most appropriate cut-off value was 2.29 ng/mL, and the sensitivity was 89.0%, the specificity was 83.0%, the positive predictive value was 84.0%, and the negative predictive value was 88.3%.The areas under the ROC curves of WBC and IL-6 for recurrent infection were 55.1%and 61.0%, respectively.Conclusions It was of great clinical application significance to monitor serum PCT level dynamically for the diagnosis and differential diagnosis of recurrent infection.