血清降钙素原检测在重症感染患者诊断中的应用价值

目的探讨血清降钙素原(PCT)检测在重症感染患者发展过程中的应用价值。方法分别将100例感染患者简单随机化法随机分为一般感染组50例,重度感染组50例,按入院1d、3d、5d、7d,采用半定量胶体金免疫结合法检测两组患者血清降钙素原水平变化。结果两组随着治疗的进展,PCT水平逐步降低,入院1d、3d、5d、7d,PCT水平比较(t=6.12,P<0.05)。结论 PCT作为单一的血清学指标,具有简便、快速的特点,对重症感染患者的诊断、治疗效果及预后的判断具有很好的临床实用性。     

尿胰蛋白酶原激活肽和血清降钙素原联合检测在大鼠胰腺炎早期诊断的意义

目的:研究尿胰蛋白酶原激活肽(TAP)和血清降钙素原(PCT)联合检测在大鼠急性坏死性胰腺炎早期诊断中的意义。方法:将72只大鼠随机分为两组,分别用1.5%和5%牛磺胆酸钠经胰胆管逆行注射制备轻症胰腺炎(MAP)和重症胰腺炎(SAP)模型。每组再分为3个亚组,分别于制模后6、12及24小时收集试验鼠尿液,采用竞争性酶联免疫吸附试验法(ELISA)检测TAP;采用双抗夹心免疫发光法测血清PCT水平,然后处死大鼠,取其胰腺观察其组织病理学改变并评分。结果:两组大鼠在制模后6、12和24小时胰腺病理评分逐渐增加,SAP组胰腺病理评分明显重于MAP组(P<0.05),尿TAP和血清PCT水平也相应增高,尿TAP和血清PCT检测的ROC曲线下面积增加,敏感度、特异度以及阳性似然比增加。结论:尿TAP和血清PCT水平与大鼠胰腺炎的严重程度相关联,二者联合检测可以增加敏感度和特异度,提高阳性似然比。     

社区获得性肺炎住院患者血清除降钙素原与肺炎严重程度和预后的关系

目的 考察血清降钙素原水平与社区获得性肺炎(CAP)住院患者严重程度和预后的关系.方法 回顾性分析住院患者数据库中,2009年7月～2010年7月收治的CAP患者的临床资料.结果 324例CAP住院患者中,212例(182例普通CAP、22例重症肺炎和14例死亡病例)纳入本研究.212例患者入院时平均血降钙素原为(...     

肝移植患者术后感染与降钙素原关系探讨

[目的]探讨血清降钙素原（PCT）在肝移植术后并发感染诊断中的临床意义。[方法]用免疫比浊法定量检测54例肝移植患者血清中的PCT和C反应蛋白（CRP）,观察两指标在无并发症患者和并发感染患者中的水平及阳性率。[结果]PCT对肝移植术后17例并发感染的诊断敏感性和特异性均为100％,明显优于CRP（P〈0．01）。[结论]血清PCT对肝移植术后并发感染的诊断有重要价值。     

Examination of the effect of procalcitonin on human leucocytes and the porcine isolated coronary artery

Background: The aim of this study was to investigate the effects of procalcitoninon the lipopolysaccharide (LPS)-induced changes in human leucocytesand porcine isolated coronary artery. Methods: Using flow cytometry, changes in forward scatter and intracellularcalcium in human neutrophils and monocytes were determined afterexposure to procalcitonin, calcitonin gene-related peptide (CGRP),LPS, and the known chemoattractants formylated methionine-leucine-phenylalanine(fMLP) and interleukin-8 (IL-8). In porcine isolated coronaryartery, the effects of procalcitonin were evaluated using thecontractile function change and the release of TNF. Results: In human neutrophils and monocytes, procalcitonin (100 nM),but not CGRP, increased forward scatter and the expression ofsurface markers (CD16 and CD14, respectively) in a similar mannerto 10 µg ml^–1 LPS. Procalcitonin, but not CGRP,also increased the proportion of cells exhibiting an increasein intracellular calcium ions similar to that produced by fMLPand IL-8. Acute exposure of the coronary artery to procalcitoninproduced a small, endothelium-independent relaxation (approximately15% of constrictor tone), but failed to modify subsequent relaxationsto CGRP. After 16 h exposure, procalcitonin (100 nM) increasedTNF release from the coronary artery equivalent to 70% of thatproduced by LPS, but did not modify the inhibitory effect ofLPS (100 µg ml^–1) on contractile responses. Conclusions: Procalcitonin has a proinflammatory effect on human leucocytesand porcine coronary artery, but it is not capable of modulatingLPS-induced changes in vascular responsiveness in vitro.     

Procalcitonin-Guided Antibiotic Use in Acute Exacerbations of Idiopathic Pulmonary Fibrosis

Object: To assess the clinical value of procalcitonin to guide antibiotic therapy in acute exacerbations of idiopathic pulmonary fibrosis. Methods: Patients with acute exacerbations of idiopathic pulmonary fibrosis were randomly assigned to the procalcitonin-guided group (antibiotic use guided by a procalcitonin threshold of 0.25 ng/ml) or the routine treatment group (antibiotic use according to routine practice). Follow up of clinical outcomes were assessed at baseline and 30 days later. Results: Baseline characteristics including demographics, clinical characteristics and laboratory results were similar between groups. PCT guidance resulted in a significant reduction of antibiotic treatment duration (8.7±6.6 compared to 14.2±5.2 days in the routine treatment group). Fewer patients were exposed to antibiotics treatment in the PCT group (26 patients) compared with the control group (35 patients). Treatment success, mortality rate, days of hospitalization and ventilation therapy were similar between the two groups. Conclusion: Procalcitonin-guided antibiotic therapy of patients with acute exacerbation of idiopathic pulmonary fibrosis may result in reduced exposure to antibiotics without adversely affecting patient outcomes.     

慢性阻塞性肺疾病患者急性加重期血清降钙素原水平变化及其临床意义

目的探讨慢性阻塞性肺疾病(COPD)患者急性加重期血清降钙素原(PCT)水平变化及其临床意义。方法选择COPD急性加重期患者103例,按治疗前痰中病原菌浓度分为感染组59例和未感染组44例。观察治疗前后血清PCT水平,并分析其与预后的关系。结果治疗前感染组血清PCT水平显著高于未感染组(P<0.01),治疗后显著降低(P<0.01),与未感染组相比差异无统计学意义(P>0.05)。随着PCT水平增加,感染组患者使用抗生素治疗时间及住院时间越长(P<0.05,P<0.01),死亡率越高(P>0.05)。结论 COPD急性加重期患者血清PCT水平升高提示可能存在细菌感染,PCT含量可作为辅助诊断、预后评估的工具。