血清降钙素原与血液细菌培养对菌血症的诊断价值

目的 探讨血清降钙素原（PCT）与血液细菌培养对菌血症的诊断价值.方法 对72例菌血症患者（菌血症组）、48例肿瘤高热患者（肿瘤组）及50例健康体检者（对照组）在入院时检测血清PCT水平,并对菌血症组进行血培养,菌血症患者在高热后24 h、48 h、72 h重复检测上述指标,比较三组血清PCT水平,并分析菌血症组应用抗生素前后血清PCT检测结果.结果 首次抽血检测PCT,菌血症组患者血清PCT阳性率为83.3％,显著高于肿瘤组的16.7％,对照组的0,差异均有统计学意义（P＜0.05）;发热后24 h、48 h、72 h,血清PCT检测的阳性率均显著高于血液细菌培养（P＜0.05）;随着培养次数的增加,血液细菌培养阳性率依次升高（P＜0.05）;感染控制患者PCT水平明显低于未控制者（P＜0.05）.结论血清PCT联合血液细菌培养可缩短诊断时间,提高菌血症的诊断率,还可指导临床抗生素正确使用,改善患者预后.

Value of serum procalcitonin and blood bacteria culture in the diagnosis of bacteremia

Objective To explore the value of serum procalcitonin （PCT） and blood bacteria culture in the diagnosis ofbacteremia.Methods Seventy-two patients with bacteremia （bacteremia group）,48 patients with tumor fever （tumor group） and 50 healthy subjects （control group） were detected for the serum levels of PCT in the first visit.The bacteremia group received blood culture every 24 h and detected for both indicators.The levels of PCT in the three groups were compared,and the results of PCT in the bacteremia group were observed before and after antibiotics treatment.Results The positive rate of PCT in the bacteremia group was 83.3%,which was significantly higher than that in the tumor group （16.7%） and the control group （0%）.The positive rate by PCT was significantly higher than that by blood bacteria culture at 24 h,48 h,and 72 h after fever.With the increase of the number of bacteria culture,the positive rate of bacteria culture was significantly increased （P〈0.05）.The level of serum PCT decreased significantly when bacteremia was in control （P〈0.05）.Conclusion Serum PCT levels combined with blood bacteria culture can shorten the diagnosis time,improve the diagnosis of bacteremia,which can also be used to guide clinical antibiotics correctly,improve the prognosis of patients.