【摘要】 目的探究降钙素原应用于诊断危重孕产妇发生细菌感染的临床价值。方法 2012年2月至2014年9月期间入住深圳市宝安区人民医院重症医学科的96例危重孕产妇纳入研究,其中存在细菌的36例为A组,无细菌感染的60例为B组;同期选取普通产科检查的孕产妇共52例作为对照组,其中存在细菌感染的C组共32例,无细菌感染的D组共20例,所有患者入科留置样本同步检测降钙素原(PCT)、白细胞(WBC)、C反应蛋白(CRP)。结果 PCT及CRP在四组的组间差异具有统计学意义F=3.90、F=4.19(P<0.05),A、C组的PCT(23.18±21.0)、(1.38±0.88)ng/ml)与B、D组(34.0±45.8)、0.3±0.2)ng/ml)组间差异具有统计学意义(P<0.05),但A组与C组间差异无统计学意义(P>0.05),CRP则发现仅A(128.63±86.5)mg/L)与B组(25.6±47.7)mg/L)差异有统计学意义(P<0.05)。采用受试者工作特征(ROC)曲线计算结果显示PCT对诊断孕产妇发生感染的曲线下面积为0.953,敏感性及特异性达90.6%和91.3%,约登指数最大值相应的PCT浓度:1.95 ng/ml为预测感染的最佳临界值;优于CRP的62.5%及68.3%(曲线下面积:0.701、15.5 mg/L)、WBC的56.3%和56.3%(曲线下面积:0.564、11.21×109/L)。结论 PCT在危重孕产妇中鉴别诊断发生细菌感染具有较强的敏感性及特异性。更多还原

【Abstract】 Objective To explore the clinical value of measuring procalcitonin on assessing critical maternal infection.Methods During February 2012 and September 2014, 96 cases with severe maternal puerpera(36 case with infection in group A, 60 cases without infection in group B), the control group of 52 female(32 case with infection in group C,20 cases without infection in group D), admitted in the critical care departments of the people hospital of Baoan district,Shenzhen, were separated in two groups in study based on condition of infection. At the time of admission, procaleitronin(PCT),white blood cell(WBC) and C-reaction protein(CRP) were detected in all cases. Results Statistically significant differences of PCT and CRP had been revealed in fourgroups(F=3.90 and F=4.19,P<0.05). PCT levels were different among group A or group B and group C or group D((23.18 ±21.0) /(1.38 ±0.88) vs(34.0 ±45.8) /(0.3 ±0.2)ng / ml,P<0.05), but significant differences of CRP could only find between group A and group B(128.63±86.5) vs(25.6±47.7)mg / L,P<0.05). The result of The operating characteristic curve indicated the best prediction value of PCT on infection for severe maternal puerpera was 1.95 ng / m L,with 90.6% sensitivity and 91.3% specificity, higher than CRP and white blood cell count. Conclusion Our research confirmed the good performance of PCT on predicting infection for severe maternal puerpera.更多还原