摘要
目的探讨血清降钙素原(serum procalcitonin,PCT)、C反应蛋白(C-reactive protein,CRP)对急诊血流感染的预测价值。方法回顾性分析北京积水潭医院急诊科2017年1月至2017年12月临床诊断为血流感染并抽取血培养,同时检测PCT、CRP等指标的385例患者的临床资料。对104例血培养阳性患者和280例血培养阴性患者的PCT、CRP的测定结果进行统计学分析。结果血培养阳性组PCT阳性率为94.17%,血培养阴性组PCT阳性率为25.81%,差异有显著性(P<0.05)。血培养阳性组CRP阳性率为97.09%,血培养阴性组CRP阳性率为90.07%,差异有显著性(P<0.05)。以血清PCT水平2.98ng/ml为界值预测血培养阳性的敏感度为88.5%,特异性为93.0%(95%CI:0.911~0.969),阳性预测值和阴性预测值分别为81.5%和95.5%。以血清CRP水平108.5mg/L为界值预测血培养阳性的敏感度为69.2%,特异性为74.5%(95%CI:0.698~0.810),阳性预测值和阴性预测值分别为47.8%和84.7%。结论血清PCT、CRP对急诊血流感染有一定的预测价值,可为急诊医师早期识别血流感染提供参考。
Objective To evaluate the predictive value of serum calcitonin(PCT)and c-reactive protein(CRP)in emergency patients with bloodstream infection.To provide reference for early identification of bloodstream infection by emergency physicians.Method Retrospective study of clinical data of 385 patients in the emergency department of Beijing Jishuitan Hospital from January 2017 to December 2017 for clinical diagnosis of bloodstream infection and extraction of blood culture,as well as the detection of PCT,CRP and other biomarkers.The results of the determination of PCT and CRP in 104 patients with positive blood culture and 280 cases of negative blood culture were analyzed statistically.Result 104 cases of positive blood culture in 384 patients with clinical diagnosis of bloodstream infection,the positive rate of PCT is 94.17 %,280 cases of negative blood culture,the positive rate of PCT is 25.81 %,the difference is statistically significant(P<0.05).97.09% positive rate of CRP in positive blood culture group,90.07% positive rate of CRP in negative blood culture group,the difference is statistically significant(P<0.05).When the serum PCT level was 2.98 ng/ml,the sensitivity to positive blood culture was 88.5%,the specificity was 93.0%,(95% CI:0.911-0.969),and the positive predictors and negative predictors were 81.5% and 95.5%,respectively.When the serum CRP level was 108.5 mg/L,the sensitivity to positive blood culture was 69.2%,the specificity was 74.5%,(95%CI:0.698-0.8 1 0),and the positive predicted and negative predicted values were 47.8% and 84.7%,respectively.Conclusion PCT and CRP have certain positive predictive value and negative predictive value for emergency blood flow infection,which can provide some reference for early identification of blood flow infection by emergency physicians.
作者
刘妍
皮春梅
崔北辰
王聪
赵斌
LIU Yan;PI Chun-mei;CUI Bei-chen;WANG Cong;ZHAO Bin(Emergency Department, Beijing Jishuitan Hospital, Beijing 100035, China)
出处
《中国医刊》
CAS
2019年第8期865-867,共3页
Chinese Journal of Medicine
关键词
血清降钙素原
C反应蛋白
血培养
血流感染
Serum procalcitonin
C reactive protein
Blood culture
Bloodstream infection
