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目的探讨降钙素原(procalcitonin,PCT)在血流感染中的临床价值。方法回顾性分析2015年1月至2016年9月血流感染患者的临床资料、血培养和PCT结果,参照血培养结果评估PCT的临床意义。结果收集8 710例疑似血流感染患者资料,与阴性血培养结果相比,PCT在革兰阴性细菌血流感染中明显升高(7.36 ng/ml,95%CI4.69～8.82 ng/ml,P<0.01),在革兰阳性细菌(4.77 ng/ml,95%CI 3.35～6.04 ng/ml,P<0.01)和真菌血流感染(1.30 ng/ml,95%CI 0.79～2.98 ng/ml,P<0.01)的患者中稍高,但污染菌的则不变。PCT对血流感染的诊断临界值为1.1 ng/ml,特异性、灵敏度、阳性预测值和阴性预测值分别为81.0%,79.0%,25.8%和93.1%。结论 PCT能快速区分血流感染与非血流感染,具有很好的临床诊断价值。
Objective To investigate the clinical value of procalcitonin (PCT) in bloodstream infection. Methods The clinical data, blood culture and PCT results of patients with bloodstream infection from January 2015 to September 2016 were retrospectively analyzed. The clinical significance of PCT was evaluated with reference to the blood culture results. Results A total of 8 710 patients with suspected bloodstream infections were enrolled. PCT was significantly higher in gram-negative bacterial bloodstream infections than in negative blood cultures (7.36 ng / ml, 95% CI, 4.69-8.82 ng / ml, (95% CI 0.79 ~ 2.98 ng / ml, P <0.01), and the positive rate of fungal bloodstream infection (1.30 ng / ml, 95% CI 0.79-2.98 ng / ml , P <0.01) patients slightly higher, but the pollution of bacteria is not changed. The diagnostic threshold of PCT for bloodstream infection was 1.1 ng / ml, with specificity, sensitivity, positive predictive value, and negative predictive value of 81.0%, 79.0%, 25.8%, and 93.1%, respectively. Conclusion PCT can quickly distinguish between bloodstream infection and non-bloodstream infection and has good clinical diagnostic value.