降钙素原在侵袭性真菌感染诊断中的应用价值研究

目的 评价血清降钙素原(PCT)在侵袭性真菌感染(IFI)诊断中的应用价值.方法 纳入有全身炎症反应综合征(SIRS)表现、临床感染、标本培养结果阳性的患者,同时半定量免疫色谱法测定PCT.结果 当PCT＜0.5 ng/ml,真菌感染组36例占73.47％,细菌感染组5例占9.62％；当PCT≥0.5 ng/ml时,诊断细菌感染的敏感度为90.38％,特异度为73.47％,阳性预测值78.33％,阴性预测值87.8％,PCT＜0.5 ng/ml可高度提示真菌感染.结论 对于有临床感染征像的患者,PCT＜0.5 ng/ml时,高度提示真菌感染;PCT可以作为真菌与细菌鉴别的一个有效的临床辅助诊断指标.

Investigation on application value of serum procalcitonin in diagnosis of invasive fungal infections

OBJECTIVE To evaluate the application value of serum procalcitonin(PCT) in diagnosing invasive fungal infection(IFI).METHODS Patients who had symptoms of systemic inflammatory response syndrome(SIRS),clinical infection and positive outcomes of specimen culture were recruited and their serum procalcitonin levels were measured by semi-quantitative immunochromatographic method.RESULTS There were 36 cases(73.47%) in fungal infection group and 5 cases(9.62%) in bacterial infection when PCT was less than 0.5 ng/ml.When PCT ≥ 0.5ng/ml,the sensitivity,specificity,positive predictive value(PPV) and negative predictive value(NPV) in diagnosing bacterial infection were 90.38%,73.47%,78.33% and 87.8%,respectively.It could highly indicated fungal infection when the serum procalcitonin was less than 0.5 ng/ml.CONCLUSION For the patients who have symptoms of clinical infections,it can effectively indicate fungal infection when their serum procalcitonin levels are less than 0.5 ng/ml;the serum procalcitonin can serve as an indicator assisting the clinical diagnosis.