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目的 :探讨降钙素原对预测危重患者院内获得性菌血症的价值。方法 :回顾性分析2010年5月—2013年10月上海长征医院急救科患者的临床资料,行降钙素原、内毒素、C反应蛋白、白细胞计数及血培养等,根据院内获得性菌血症诊断标准对不同血培养结果之间的各炎症指标进行比较,并绘制其预测菌血症的ROC曲线。结果:血培养阳性组中降钙素原、内毒素及C反应蛋白高于血培养阴性组(P<0.05),其中革兰氏阴性菌组升高更明显,白细胞计数在各组间无显著差异;降钙素原ROC曲线下面积(95%CI=0.81,0.78~0.85,P<0.001),有助于预测菌血症。结论:降钙素原对于预测危重患者院内获得性菌血症有一定价值。
Objective: To investigate the value of procalcitonin in predicting nosocomial bacteremia in critically ill patients. Methods: The clinical data of emergency department of Shanghai Changzheng Hospital from May 2010 to October 2013 were retrospectively analyzed. Prostatokin, endotoxin, C-reactive protein, white blood cell count and blood culture were analyzed. Syndrome Diagnostic Criteria The inflammatory markers between different blood culture results were compared and the ROC curve of the predicted bacteremia was plotted. Results: The levels of procalcitonin, endotoxin and C-reactive protein in blood culture positive group were higher than those in blood culture negative group (P <0.05), especially in Gram-negative bacteria group, and the white blood cell count was not significant among the groups (95% CI = 0.81,0.78-0.85, P <0.001), which is helpful for the prediction of bacteremia. CONCLUSION: Procalcitonin is of value in predicting nosocomial bacteremia in critically ill patients.