本文選題：降鈣素原 + 血培養(yǎng)陽性��； 參考：《中華醫(yī)院感染學(xué)雜志》2016年16期

【摘要】：目的探討血清降鈣素原(PCT)預(yù)測(cè)血培養(yǎng)陽性的臨床應(yīng)用價(jià)值。方法采用回顧性分析研究,以2012年12月-2014年12月同時(shí)進(jìn)行PCT和血培養(yǎng)檢測(cè)1 164例患者為研究對(duì)象,根據(jù)血培養(yǎng)結(jié)果分為陽性組和陰性組,比較兩組間PCT、C-反應(yīng)蛋白(CRP)水平等實(shí)驗(yàn)室指標(biāo)的差異。結(jié)果血培養(yǎng)陽性組PCT、CRP明顯高于血培養(yǎng)陰性組,差異有統(tǒng)計(jì)學(xué)意義(P0.001);單因素logistics回歸分析顯示,PCT、CRP及體溫均為菌血癥預(yù)測(cè)因子,差異有統(tǒng)計(jì)學(xué)意義(P0.001),多因素logistics回歸分析顯示,校正年齡、抗菌藥物預(yù)處理因素后,年齡、PCT、CRP是預(yù)測(cè)血培養(yǎng)陽性的獨(dú)立預(yù)測(cè)因子;血清PCT預(yù)測(cè)血培養(yǎng)陽性ROC曲線下面積為0.800,當(dāng)截?cái)帱c(diǎn)為PCT0.05ng/ml時(shí),PCT預(yù)測(cè)血培養(yǎng)陽性的敏感性高達(dá)96%,與其他臨床實(shí)驗(yàn)室指標(biāo)相比,PCT預(yù)測(cè)血培養(yǎng)陽性診斷價(jià)值最高;在PCT0.05ng/ml時(shí),菌血癥發(fā)生風(fēng)險(xiǎn)低,而PCT0.5ng/ml時(shí),菌血癥發(fā)生風(fēng)險(xiǎn)高,有利于早期診斷和病情檢查,合理使用抗菌藥物。結(jié)論 PCT預(yù)測(cè)血培養(yǎng)陽性是非常有意義的,比CRP、WBC計(jì)數(shù)和其他臨床實(shí)驗(yàn)室指標(biāo)均要好,而且血清PCT檢測(cè)能夠減少患者的血培養(yǎng)數(shù)量及醫(yī)療成本,實(shí)施更合理的衛(wèi)生保健資源分配。
[Abstract]:Objective to investigate the clinical application value of serum calcitonin (PCT) in predicting the positive blood culture. Methods a retrospective analysis was carried out in 1164 patients with PCT and blood culture in December December 2012 -2014. The results were divided into positive and negative groups according to the result of blood culture, and compared the level of PCT, C- reactive protein (CRP) among the two groups. Results the difference of laboratory indexes. Results the positive blood culture group PCT, CRP was significantly higher than the negative blood culture group, the difference was statistically significant (P0.001). The single factor logistics regression analysis showed that PCT, CRP and body temperature were all predictive factors of bacteremia, the difference was statistically significant (P0.001). The multiple factor logistics regression analysis showed that the correction age, the antibacterials were pretreated. After the treatment, age, PCT, and CRP were independent predictors of positive blood culture, and serum PCT predicted that the area under the positive ROC curve of blood culture was 0.800. When the truncated point was PCT0.05ng/ml, the sensitivity of PCT to predict the positive blood culture was up to 96%. Compared with other clinical laboratory indicators, PCT predicted the positive diagnostic value of blood culture; in PCT0.0, the value of the positive blood culture was the highest; in PCT0.0 At the time of 5ng/ml, the risk of bacteremia is low and the risk of bacteremia is high at PCT0.5ng/ml. It is beneficial to early diagnosis and condition examination and rational use of antibiotics. Conclusion PCT is very meaningful to predict positive blood culture. It is better than CRP, WBC count and other clinical laboratory indexes, and serum PCT detection can reduce the blood culture of patients. To provide more reasonable allocation of health care resources by maintaining quantity and medical costs.
【作者單位】： 浙江省臺(tái)州醫(yī)院檢驗(yàn)科;
【基金】：浙江省科技廳基金資助項(xiàng)目(2016C33SA800035)
【分類號(hào)】：R446.1

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