【摘要】 目的探讨血清前降钙素(PCT)检测对进入重症监护病房(ICU)患者发生严重感染和败血症的诊断价值。方法选择ICU患者121例,其中无感染患者24例作对照组,全身炎症反应综合征(SIRS)患者31例,败血症患者26例,重症败血症患者25例和败血症休克患者15例。检测血清PCT水平,应用受试者工作特征曲线(ROC)进行评价。结果败血症组(平均2.39ng/mL)、重症败血症组(4.64ng/mL)和败血症休克组(5.86ng/mL)与对照组(0.59ng/mL)相比,PCT水平有显著差异,并且随感染程度加重有升高趋势,差异有统计学意义(P<0.05)。感染组(败血症组+重症败血症+败血症休克组)PCT水平高于非感染组(对照组+SIRS组),差异有统计学意义(P<0.05)。PCT水平在ROC曲线下的面积为0.897,临床诊断的临界点是1.0ng/mL,灵敏度和特异度分别为85.84%和80.00%。结论经ROC曲线评价,PCT可以作为ICU患者感染和败血症的鉴别诊断指标。更多还原

【Abstract】 ObjectiveThe study was designed to evaluate the diagnostic value of procalcitonin in infections in intensive care units.MethodsOf the 121 ICU patients,24 patients without infection were taken as control;31 patients had systematic inflammatory response syndrome(SIRS),26 with sepsis,25 with severe sepsis and 15 with sepsis shock.Serum procalcitonin level was determined.Receiver operating characteristic(ROC) curve was used to evaluate the diagnostic value of procalcitonin.ResultsProcalcitonin levels in sepsis(2.39 ng/mL);severe sepsis(4.64 ng/mL) and sepsis shock group(5.86 ng/mL) were significantly different from control(0.59 ng/mL) and SIRS group.Procalcitonin level in infection group(sepsis + severe sepsis + sepsis shock) was higher than that in non-infection group(control + SIRS group).The area under ROC of procalcitonin was 0.897.The clinical diagnostic cutoff of procalcitonin was 1.0 ng/mL.Its sensitivity and specificity were 85.84% and 80.00%.ConclusionsBased on ROC evaluation,procalcitonin seems a sensitive and specific marker of infection and sepsis in ICU patients.更多还原