血清降钙素原与感染性疾病的相关性分析(2)(4)

血清降钙素原与感染性疾病的相关性分析(2

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果作者认为,当血清PCT<0 5 g L-1时多见于病毒感染或轻微的细菌局部感染,故一般可不考虑使用抗生素,或仅以口服抗菌药物即可;当0 5 g L PCT<

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2.0 g L时,多见于细菌感染和个别病毒感染,故应视临床具体情况选用抗生素;当2.0 g L-1 PCT<10.0 g L-1时,多见于较严重的细菌感染,应强调选用抗生素;当PCT 10 0 g L时,主要见于败血症、流行性脑脊髓膜炎等严重细菌感染患者,个别见于极严重的病毒感染、全身情况极差的患者,故必须考虑选用抗生素,且多需联合用药。

本研究同时发现,血清PCT值可以反映器官功能状况。血清PCT水平与MODS及转归明显相关,其水平越高,MODS的发生率越高,预后越差。5例死亡患者血清PCT均阳性,其中3例2.0 g L PCT<10.0 g L-1,2例PCT 10.0 g L-1。由此可以推测,感染性疾病患者在由SIRS向MODS的发生、发展过程中,PCT可能发挥着重要作用。

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[收稿日期]2002 06 27

Studyontherelationshipbetweenserumlevelsofprocalcitonin

andacuteinfectiousdiseases

WANGMing-ming,CUISu-nan,SUNYu-qiu,ZHANGJuan,ZHANGJing-yao

(Ji nanInfectiousHospital,Ji nan250021,China)

Abstract:Objective Toinvestigateclinicalsignificancesofdetectingserumprocalcitonin(PCT)invariousinfectiousdisease,exploretherelationshipbetweenPCTandinfection.Methods SerumPCTweremeasuredbysem-iquantitativesolid-phaseimmunoassayin356patientswithdifferentkindsofinfectiousdiseases,andthenwerecategorizedintofourgroups:PCT<0 5 g L-1,0 5 g L-1 PCT<2.0 g L-1,2 0 g L-1 PCT<10.0 g L-1andPCT 10.0 g L-1.Therela-tionshipbetweenserumlevelsofprocalcitoninandviralinfectionorbacterialinfectionwasanalysed.Results IfPCTlevels 0 5 g Lwastakenasdiagnosticstandardandsystemicinfectiousreactionsyndromeparameterswerecombined,thetest s

sensitivity,specificity,positivepredictivevalue,negativepredictivevalue,positivelikelihoodratio,negativelikelihoodratioandaccuracyratioindiagnosingbacterialinfectiousdiseaseswas98 7%,72 0%,49 4%,99 5%,3 53,0 018and77 80%,re-spectively.Conclusion Thestudysuggeststhatsem-iquantitativedetectionofserumPCTmighthelpustoidentifybacterialinfectionfromnon-bacterialinfection,andmightoffervaluabledataforchoosingantibiotictherapy.Ontheotherhand,PCTlev-elsmightreflectthediseaseseverity.

Keywords:procalcitonin;infectiousdisease;sem-iquantitativesolid-phaseimmunoassay;systemicinfectiousreactionsyn-drome

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