安徽医学
安徽醫學
안휘의학
Anhui Medical Journal
2015年
11期
1342-1345
,共4页
降钙素原%感染性疾病%细菌感染
降鈣素原%感染性疾病%細菌感染
강개소원%감염성질병%세균감염
Procalcitonin%Infectious Disease%Bacterial Infection
目的：研究重症患者抗感染治疗前及过程中血清降钙素原（PCT）、C 反应蛋白（CRP）及白细胞计数（WBC）的变化对指导抗菌药物的选择和疗效判断的价值。方法选取2013年1月至2014年12月收治的200例住院患者，在明确感染的前提下结合细菌培养结果分为细菌感染组130例和非感染组70例，对其进行血清 PCT、CRP 和 WBC 检测，比较两组患者治疗前和治疗过程中 PCT、CRP 及 WBC 计数之间的差别，并计算 PCT、CRP 和 WBC 诊断细菌感染的敏感度和特异度。结果细菌感染组患者 PCT 和CRP 检测值高于非感染组患者（ P <0.05），而 WBC 两组间差异无统计学意义（ P >0.05）；PCT 升高诊断细菌感染的敏感性（95.4%）和特异性（91.4%）要高于 CRP 和 WBC（P <0.05）；在使用抗菌药物治疗前，革兰阴性菌（G -菌）感染组患者的 PCT 高于革兰阳性菌（G +菌）感染组（P <0.05）。抗菌药物治疗后，PCT 水平下降幅度较 CRP 大（P <0.05），WBC 变化幅度较小（P <0.05）。结论 PCT 可作为感染性疾病初步诊断的指标之一，并可用于初步判断病原体及指导判断抗菌药物的疗效。
目的：研究重癥患者抗感染治療前及過程中血清降鈣素原（PCT）、C 反應蛋白（CRP）及白細胞計數（WBC）的變化對指導抗菌藥物的選擇和療效判斷的價值。方法選取2013年1月至2014年12月收治的200例住院患者，在明確感染的前提下結閤細菌培養結果分為細菌感染組130例和非感染組70例，對其進行血清 PCT、CRP 和 WBC 檢測，比較兩組患者治療前和治療過程中 PCT、CRP 及 WBC 計數之間的差彆，併計算 PCT、CRP 和 WBC 診斷細菌感染的敏感度和特異度。結果細菌感染組患者 PCT 和CRP 檢測值高于非感染組患者（ P <0.05），而 WBC 兩組間差異無統計學意義（ P >0.05）；PCT 升高診斷細菌感染的敏感性（95.4%）和特異性（91.4%）要高于 CRP 和 WBC（P <0.05）；在使用抗菌藥物治療前，革蘭陰性菌（G -菌）感染組患者的 PCT 高于革蘭暘性菌（G +菌）感染組（P <0.05）。抗菌藥物治療後，PCT 水平下降幅度較 CRP 大（P <0.05），WBC 變化幅度較小（P <0.05）。結論 PCT 可作為感染性疾病初步診斷的指標之一，併可用于初步判斷病原體及指導判斷抗菌藥物的療效。
목적：연구중증환자항감염치료전급과정중혈청강개소원（PCT）、C 반응단백（CRP）급백세포계수（WBC）적변화대지도항균약물적선택화료효판단적개치。방법선취2013년1월지2014년12월수치적200례주원환자，재명학감염적전제하결합세균배양결과분위세균감염조130례화비감염조70례，대기진행혈청 PCT、CRP 화 WBC 검측，비교량조환자치료전화치료과정중 PCT、CRP 급 WBC 계수지간적차별，병계산 PCT、CRP 화 WBC 진단세균감염적민감도화특이도。결과세균감염조환자 PCT 화CRP 검측치고우비감염조환자（ P <0.05），이 WBC 량조간차이무통계학의의（ P >0.05）；PCT 승고진단세균감염적민감성（95.4%）화특이성（91.4%）요고우 CRP 화 WBC（P <0.05）；재사용항균약물치료전，혁란음성균（G -균）감염조환자적 PCT 고우혁란양성균（G +균）감염조（P <0.05）。항균약물치료후，PCT 수평하강폭도교 CRP 대（P <0.05），WBC 변화폭도교소（P <0.05）。결론 PCT 가작위감염성질병초보진단적지표지일，병가용우초보판단병원체급지도판단항균약물적료효。
Objective To study the value of serum procalcitonin(PCT),C-reactive protein(CRP),white blood cell count(WBC) changes before and during the anti-infection treatment in guiding choice of antimicrobial drugs and therapeutic evaluation in critically ill pa-tients. Methods On the premise of identified infection,together with the results of bacterial culture,200 cases of hospitalized patients ever treated from Jan 2013 to Dec 2014 were divided into bacterial infection group(130 cases)and non - bacterial infection group(70 cases). The serum levels of PCT,CRP and WBC were detected and then their differences between the two groups before and during treatment were compared. The sensitivity and specificity of PCT,CRP and WBC for diagnosis of bacterial infections were calculated. Results The esti-mated values of PCT and CRP of bacterial infection patients were significantly higher than those of non-bacterial infection patients( P <0. 05),but the WBC difference between the two groups was not statistically significant(P > 0. 05). Elevated PCT level resulted in highersensitivity(95. 4% )and specificity(91. 4% )for diagnosis of bacterial infection than those of increased CRP and WBC. Before use of anti-microbial drugs,the PCT level in G - bacterial infection patients was significantly higher than that in G + bacterial infection patients(P <0. 05). But after antibiotic therapy,the decline of PCT level was significantly larger than that of CRP(P < 0. 05),while the WBC level changed slightly. Conclusion Serum PCT level could be applied as an indicator of preliminary diagnosis of infectious diseases,and used to initially determine the pathogens and the efficacy of antibiotics.
