血清降钙素原检测对于肾移植术后肺部感染的诊断价值

目的：与内毒素和C反应蛋白（ CRP）检测结果进行比较，探讨血清降钙素原（ PCT）检测在肾移植术后肺部感染诊断中的临床意义及其应用价值。方法回顾性分析2010年2月至2013年9月武汉大学移植医学中心98例肾移植术后并发肺部感染的受者临床资料。根据肺部感染的病原体诊断标准将受者分为细菌组（48例）和非细菌组（50例），比较PCT、内毒素和CRP检测3种方法诊断肾移植术后细菌性肺部感染的灵敏度和特异度，比较3种方法对确诊肾移植术后并发细菌性肺部感染受者的阳性诊断结果。结果 PCT 检测灵敏度为95.8％，特异度为94．0％；内毒素检测灵敏度为77．1％，特异度为72．0％；CRP检测灵敏度为52．1％，特异度为58．0％。血清PCT检测细菌组受者阳性结果高于内毒素和CRP检测（χ2＝7.36，10．04， P均＜0．05）。结论血清PCT检测对于肾移植术后细菌性肺部感染的临床诊断价值高于内毒素和CRP，可作为肾移植受者是否并发细菌性肺部感染的优选诊断指标。

Diagnostic value of serum procalcitonin for pulmonary infection after kidney transplantation

Objective To investigate the clinical significance and application value of serum procalcitonin （ PCT） in the diagnosis of pulmonary infection after renal transplantation .Methods A total of 98 patients, who complicated with pulmonary infection after renal transplantation from February 2010 to September 2013 , were retrospectively analyzed .The patients were divided into bacterial group （48 patients） and non-bacterial group （50 patients） according to the pathogen diagnostic criteria .The data （ including PCT , endotoxin and C-reactive protein ） had a statistical analysis .Results The sensitivity and specificity of PCT , endotoxin and C-reactive protein were 95.8%and 94.0%, 77.1%and 72.0%, and 52.1% and 58.0%, respectively.Compared with the endotoxin and C-reactive protein, the positive result of serum PCT in the bacteria group had an extremely significant difference （χ2 =7.36, 10.04, all P〈0.05）.Conclusion The test of PCT has an obvious clinical diagnosis value on pulmonary bacterial infection after renal transplantation .It can be preferentially used as a monitoring index for pulmonary bacterial infection after renal transplantation than rather endotoxin and C-reactive protein .