三种感染性疾病降钙素原水平比较

目的探讨降钙素原(PCT)辅助细菌性脓毒症诊断的可靠性,以及在革兰阴性菌和革兰阳性菌感染鉴别中的意义。方法本项目收集的研究对象为2013年1月-2018年12月,深圳市龙岗中心医院感染科收治的细菌性脓毒症患者131例、登革热患者30例,流行性感冒患者30例。分别检测三组患者体内PCT水平。结果脓毒症组PCT为2.30(0.18,100)ng/ml高于登革热组0.27(0.09,0.54)ng/ml(P<0.001)及流感组0.04(0.01,0.35)ng/ml(P<0.001);而登革热组与流感组相比,PCT浓度则无统计学意义(P=0.128);其次,在脓毒症组中,革兰阴性菌感染者的PCT浓度高于革兰阳性菌感染者(P<0.001)。结论 PCT高浓度对细菌性脓毒症的诊断精确可靠。另外,革兰阴性菌和革兰阳性菌感染者体内降钙素原的浓度明显不同,这可作为两种细菌感染的鉴别依据。

Procalcitonin analysis of three infectious diseases

OBJECTIVE To investigate the reliability of procalcitonin(PCT) in assisting the diagnosis of bacterial sepsis, and its significance in the differentiation of gram-negative and gram-positive bacterial infections. METHODS The 131 patients with bacterial sepsis and 30 cases with dengue fever admitted to the Department of Infectious Diseases, Shenzhen Longgang Central Hospital from January 2013 to December 2018 were selected as the study subject. The experimental influenza group included 30 patients with influenza in our laboratory. The levels of PCT in three groups of patients were detected. RESULTS The PCT of the sepsis group was 2.30(0.18, 100), significantly higher than that of dengue group(0.27(0.09, 0.54), P<0.001) and influenza group(0.04(0.01, 0.35), P<0.001). There was no significant difference of PCT concentration between the dengue fever group and the control group(P<0.128). Secondly, in the sepsis group, the PCT concentration of gram-negative bacteria infection was significantly higher than that of gram-positive bacteria infection(P<0.001). CONCLUSION The high concentration of PCT is accurate and reliable in the diagnosis of bacterial sepsis. In addition, the concentration of procalcitonin in people infected with gram-negative bacteria and gram-positive bacteria is significantly different, which can be used as the basis for distinguishing two kinds of bacterial infections.