| 血培养及降钙素原对有其他部位感染伴血流感染ICU患者的诊断价值 |
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| 引用本文： | 韩静静,徐亚青,邓艳萍,周晨亮,周红霞,吕丽琼,成于珈. 血培养及降钙素原对有其他部位感染伴血流感染ICU患者的诊断价值[J]. 中华全科医学, 2016, 14(6): 947-949. DOI: 10.16766/j.cnki.issn.1674-4152.2016.06.020 |
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| 作者姓名： | 韩静静 徐亚青 邓艳萍 周晨亮 周红霞 吕丽琼 成于珈 |
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| 作者单位： | 1. 武汉大学人民医院医院感染管理办公室，湖北 武汉 430060; |
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| 基金项目： | 中华医院感染控制研究基金(ZHYY2014-0017) |
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| 摘 要： | 目的 分析血培养及降钙素原(PCT)对有其他部位感染伴血流感染ICU患者的诊断价值。 方法 收集武汉大学人民医院2014年1—12月在ICU住院并最终判断有其他部位感染伴血流感染患者作为试验组，有其他部位感染但无血流感染患者为对照组，以出院血流感染确诊为金标，回顾性分析、比较血培养及PCT对伴其他部位感染的血流感染的诊断价值。 结果 试验组血清PCT水平较对照组高(P<0.001)；G-菌感染组PCT水平高于G+菌和真菌感染组(P<0.05)。根据ROC曲线，PCT界值可设定为12.19 ng/ml用于诊断；PCT≥12.19 ng/ml阴性预测值最高(88.38%)，可用于在血培养结果未出来之前对感染的预测；血培养阳性且PCT≥12.19 ng/ml阳性预测值最高(95.45%)、特异性最强(98.16%)，可用于判别血培养是否存在假阳性；血培养阳性或PCT≥12.19 ng/ml敏感性最高，为80.77%，提示有伴其他部位感染的血流感染的可能。 结论 血培养联合PCT检测对诊断伴其他部位感染的血流感染价值较高，可有效改善血培养由于污染所造成的假阳性以及敏感性不高所造成的假阴性，及早地作出诊断，及时为临床决策提供依据。
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| 关 键 词： | 降钙素原 血培养 血流感染 |
| 收稿时间： | 2015-08-28 |
Clinical significance of procalcitonin test and blood culture in diagnosis of blood stream infection with other sites infections |
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| Affiliation: | The Office for Infection Control,Renmin Hospital of Wuhan University,Wuhan,Hubei 430060,China |
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| Abstract: | Objective To evaluate the role of blood culture and procalcitonin(PCT) test in the diagnosis of blood stream infection with other sites of infections. Methods The patients who were with blood stream infection and other sites infections admitted to our hospital from January,2014 to December,2014 were enrolled into this study and their clinical data were retrospectively analyzed,while the patients without blood stream infection but with other sites infections were selected as the control group. Results PCT tests in the patients with blood stream infection and other sites infection were higher than that in the control group(P<0.001);PCT with G- infection were higher than patients with G+ or fungal infection(P<0.05).According to the ROC curve,12.19 ng/ml was taken as critical value.The negative predictive value for PCT level above 12.19 ng/ml was the highest (88.38%),which can be used as the predictor of removing the false positive of the blood culture.The positive predictive value and specificity of blood culture(+) and PCT above 12.19 ng/ml were the highest(95.45%;98.16%).The sensitivity of blood culture(+) or PCT tests above 12.19 ng/ml was the highest(80.77%). Conclusion The combined PCT test and blood culture can be used in the diagnosis of blood stream infection with other sites infections,which can improve the false positive and false negative of the blood culture,and provide evidence for the clinical decision-making. |
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