CAJ | 학술논문

目的：探讨降钙素原( PCT)对2型糖尿病败血症的临床意义。方法对2012年9月至2014年9月的92例入院时或入院后发热、疑似败血症的2型糖尿病患者,根据血培养结果分为败血症组和非败血症组,其中败血症组49例( G-菌34例、G+菌15例),非败血症组43例,比较两组间PCT的表达水平、糖尿病败血症组中G+菌以及G-菌PCT的表达水平、及PCT与CRP对糖尿病败血症诊断的差异。结果在92例发热的糖尿病患者中,糖尿病败血症组PCT表达水平明显高于糖尿病非败血症组(P<0.01),糖尿病败血症组患者以G-菌感染为主,且G-菌患者中PCT表达水平高于G+菌组(P<0.05)；G-菌主要以大肠埃细菌感染为主(占24.49%)；G+菌感染主要为凝固酶阴性葡萄球菌为主(占12.24%)。与传统的感染性指标CRP相比,糖尿病败血症组中PCT的AUC为0.98(95%CI：0.96~1.0),高于CRP(AUC 0.81,95%CI：0.73~0.90)。当cutoff值为8 nd/mL时,糖尿病患者中PCT诊断败血症的敏感性为85.7%,特异性为98.0%。结论 PCT水平在2型糖尿病败血症患者中早期即有显著升高,以G-菌中升高更明显,对败血症的预测价值高于CRP。
목적：탐토강개소원( PCT)대2형당뇨병패혈증적림상의의。방법대2012년9월지2014년9월적92례입원시혹입원후발열、의사패혈증적2형당뇨병환자,근거혈배양결과분위패혈증조화비패혈증조,기중패혈증조49례( G-균34례、G+균15례),비패혈증조43례,비교량조간PCT적표체수평、당뇨병패혈증조중G+균이급G-균PCT적표체수평、급PCT여CRP대당뇨병패혈증진단적차이。결과재92례발열적당뇨병환자중,당뇨병패혈증조PCT표체수평명현고우당뇨병비패혈증조(P<0.01),당뇨병패혈증조환자이G-균감염위주,차G-균환자중PCT표체수평고우G+균조(P<0.05)；G-균주요이대장애세균감염위주(점24.49%)；G+균감염주요위응고매음성포도구균위주(점12.24%)。여전통적감염성지표CRP상비,당뇨병패혈증조중PCT적AUC위0.98(95%CI：0.96~1.0),고우CRP(AUC 0.81,95%CI：0.73~0.90)。당cutoff치위8 nd/mL시,당뇨병환자중PCT진단패혈증적민감성위85.7%,특이성위98.0%。결론 PCT수평재2형당뇨병패혈증환자중조기즉유현저승고,이G-균중승고경명현,대패혈증적예측개치고우CRP。
Objective To investigate the clinical significance of PCT in type 2 diabetes mellitus with septicemia. Methods The data were collected from 92 cases of type 2 diabetic patients,who had fever and were suspected infectioned by the septicemia. Among the patients with positive blood culture,there were 15 cases with Gram-positive bacteria cultured posi-tive and 34 cases with gram-negative bacteria cultured positive. The aim was to compare the expression levels of PCT in septi-cemic patients with type 2 diabetic mellitus and non-septicemic group,the expression levels of PCT in gram-negative bacteria and gram-positive bacteria septicemia and the different significance of PCT and CRP in septicemia group. Results The ex-pression of PCT in septicemia patients was significantly higher than in non-septicemic group(P<0. 01) among 92 type 2 dia-betic patients with fever,and higher in gram-negative bacteria infection group than the gram-positive one. The Escherichia coli was the predominant species in gram-negative bacteria group causing the septicemia,accounting for 24. 49%,and the coagu-lase negative staphylococcus was dominant among the gram-positive bacteria sepsis, accounting for 12. 24%. The AUCs of PCT,CRP were 0. 98(95%CI:0. 96-1. 0),0. 81(95%CI:0. 73-0. 90). Using 8 nd/mL as the best cutoff,the sensitivity of PCT was 85. 7% and specificity was 98. 0% for type 2 diabetic mellitus with septiceia. Conclusion The level of PCT was significantly higher in type 2 diabetic mellitus with septicemia than the non-septicemia early, more significantly higher in gram-negative bacteria infection group than the gram-positive one,whose predicted value was higher than CRP.