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重症监护病房细菌性血流感染监测中C反应蛋白和降钙素原的临床意义 被引量:23

Clinical implication of C-reactive protein and procalcitonin in bloodstream bacterial infection in intensive care unit
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摘要 目的探讨C反应蛋白(CRP)和降钙素原(PCT)在重症监护病房细菌性血流感染监测中的临床意义。方法回顾性分析北京世纪坛医院重症监护病房进行血液培养的154例患者临床资料,根据血培养结果分为阳性组(n=78)和阴性者(n=76);血培养采血当日测定CRP和PCT结果,并对两组数据进行比较。血培养阳性组按革兰阳性菌(n=17)与阴性菌(n=61)再次分组,并对两小组患者的CRP和PCT水平进行比较。结果血培养阳性组CRP[中位数124(11-217)mg/L]显著高于阴性组[中位数62.3(7.39-200)mg/L,Z=-5.394,P〈0.01];阳性组PCT[中位数6.59(0.21~100)μg/L]亦显著高于阴性组[中位数0.44(0.07-60.34)μg/L,Z=-8.896,P〈0.01]。革兰阳性菌组CRP[中位数119(34.8~217)mg/L]与革兰阴性菌组[中位数126(11~205)mg/L]差异无统计学意义;但革兰阴性菌组PCT[中位数6.99(1.55~100)μg/L]显著高于革兰阳性菌组[中位数2.04(0.21~46.69)μg/L,Z=-2.663,P〈0.053。结论在重症监护病房细菌性血流感染的监测CRP和PCT具有一定参考价值;与革兰阳性菌血流感染相比,革兰阴性菌血流感染的PCT值更高。 Objective To evaluate the clinical implication of C-reactive protein and procalcitonin in bloodstream bacterial infec-tion in ICU. Methods The data of C-reactive protein and procalcitonin were analyzed retrospectively in 78 patients with positive blood culture and 76 patients with negative blood culture. C-reactive protein and procaleitonin were compared between these two patient groups. The C-reactive protein and procalcitonin values were also compared between the patients with gram-positive bloodstream infection (n = 17) and those with gram-negative bloodstream infection (n = 61). Results The median (range) C-reac-tive protein level [124 (11-217) mg/L] was significantly higher in the patients with positive blood culture than in those with negative blood culture [62.3 (7.39-200) mg/L, Z = - 5. 394, P〈0.01 )]. The procalcitonin level was significantly higher in the patients with positive blood culture [-6. 59 (0.21-100) μg/L] than in those with negative blood culture [(0.44 (0. 07-60.34) μg/L) (Z= - 8. 896, P〈0.01)]. C-reactive protein level did not show significant diference between the patients with gram-positive bloodstream infection [119 (34.8-217) mg/L] and those with gram-negative bloodstream infection [126 (11-205) mg/L]. However, the procalcitonin level was significantly higher in the patients with gram-negative bloodstream infection [6.99 (1.55-100) μg/L] than in those with gram-pos-itive bloodstream infection [2.04 (0. 21-46.69) μg/L, Z = - 2.663, P〈0. 05]. Conclusions C-reactive protein and procalcitonin show clinical implications in monitoring bloodstream bacterial infection in ICU. Procalcitonin level is higher in the patients with gram-negative bloodstream infection than in those with gram-positive bloodstream infection.
作者 杨朵 张曼
出处 《中国感染与化疗杂志》 CAS 北大核心 2014年第1期29-31,共3页 Chinese Journal of Infection and Chemotherapy
关键词 重症监护病房 C反应蛋白 降钙素原 血流感染 intensive care unit C-reactive protein procalcitonin bloodstream infection
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