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目的探讨痛风性关节炎伴发热患者降钙素原(PCT)水平变化与细菌性感染的鉴别意义。方法收集医院2014年1月-2015年6月收治的原发性痛风性关节炎患者138例,其中无发热无感染组(A组)60例、发热无感染组(B组)42例以及发热伴感染组(C组)36例,分析3组间血清PCT水平差异。结果 3组PCT水平分别为(0.14±0.09)ng/ml、(0.37±0.25)ng/ml以及(1.03±0.52)ng/ml,3组间差异均有统计学意义(P<0.01)。ROC曲线显示PCT诊断痛风患者发热伴细菌性感染的的最佳切点是0.76 ng/ml,敏感性66.7%,特异性95.2%。结论痛风性关节炎患者伴发热是血清PCT升高水平可作为判断细菌性感染的有效指标,进而指导临床抗菌素的使用。
Objective To investigate the differential significance of procalcitonin (PCT) levels and bacterial infection in patients with gouty arthritis and fever. Methods A total of 138 patients with primary gouty arthritis admitted to our hospital from January 2014 to June 2015 were enrolled. Among them, 60 were in the non-infected group (group A), 42 were in the non-infected group (group B), and were fever With infection group (C group) 36 cases, analysis of the difference between the three groups of serum PCT levels. Results The PCT levels in the three groups were (0.14 ± 0.09) ng / ml, (0.37 ± 0.25) ng / ml and (1.03 ± 0.52) ng / ml, respectively. There were significant differences among the three groups (P <0.01). The ROC curve showed that the best cut point for PCT diagnosis of gout fever with bacterial infection was 0.76 ng / ml, with a sensitivity of 66.7% and a specificity of 95.2%. Conclusion Gout with fever in patients with gouty arthritis is an elevated serum level of PCT can be used as an effective indicator to determine bacterial infections, and thus guide the use of clinical antibiotics.