血清降钙素原在诊断尿脓毒血症中的意义

Role of procalcitonin in the diagnosis of urinary sepsis

摘要:

目的：探讨血清降钙素原（procalcitonin，PCT）在诊断尿脓毒血症中的临床意义。方法：41例尿脓毒血症患者为尿脓毒血症组，79例普通泌尿道感染患者对照组，检测２组患者PCT、超敏C反应蛋白（hypersensitive C-reactive protein，hs-CRP）、白细胞（white blood cells，WBC）及中性粒细胞水平；绘制受试者工作特征（receiver operating characteristic，ROC）曲线，评价PCT及相关炎症指标鉴别尿脓毒血症高危患者的能力，并对PCT与hs-CRP、WBC及中性粒细胞进行双变量相关性分析。结果：与对照组比较，尿脓毒症组PCT浓度（μg/L）、hs-CRP（mg/L）、WBC（×109个/L）及中性粒细胞（×109个/L）均明显增高（PCT浓度：3.113±1.953 vs. 0.057±0.0550；hs-CRP：18.820±15.460 vs. 7.440±14.520；WBC：12.860±4.002 vs. 8.150±4.630；中性粒细胞：90.335±3.975 vs. 74.30±15.40），差异均有统计学意义（P＜0.05）。ROC曲线分析显示，PCT的曲线下面积（area under the curve，AUC）为1，高于hs-CRP、WBC、中性粒细胞（AUC分别为0.813、0.875、0.984）；且PCT为2.000 μg/L时，敏感性为90.2％，特异性为100％，优于其他传统炎症指标。双变量相关性分析显示，PCT与WBC和中性粒细胞数均呈显著正相关，分别为（rs=0.609，P=0.000；rs=0.057，P=0.000），而与hs-CRP有相关性（rs=0.213，P=0.020）。结论：PCT在诊断尿脓毒血症具有较高的敏感度和特异度，有助于尿脓毒血症的早期诊断及早期治疗。

Abstract:

Objective：To study the clinical significance of procalcitonin（PCT） in the diagnosis of urinary sepsis. Methods：Totally 41 patients with urinary sepsis and 79 patients with urinary tract infection were included in the study. The levels of PCT，hypersensitive C-reactive protein（hs-CRP），white blood cells（WBC） and neutrophil levels were detected in both groups. Receive operating characteristic（ROC） curve was drawn to evaluate the ability of PCT and related inflammatory parameters in assessing risk factors in patients with urinary sepsis. The correlation between PCT and hs-CRP，WBC and neutrophil was analyzed． Results：Compared with those of patients with urinary tract infection ，the levels of PCT（μg/L），hs-CRP（mg/L），WBC（×109/L） and neutrophil（×109/L） were signifi－cantly higher（PCT：3.113±1.953 vs. 0.057±0.0550，hs-CRP：18.82±15.460 vs. 7.440±14.52，WBC：12.860±4.002 vs. 8.15±4.63，neutrophil：90.335±3.975 vs. 74.30±15.40），with statistical significances（all P<0.05）. ROC curve displayed that area under the curve（AUC） of PCT was 1，higher than those of hs-CRP，WBC and neutrophils（0.813，0.875，0.984，respectively）. When PCT was 2.000 μg/L，the sensitivity was 90.2％ and specificity was 100％，better than those of other traditional markers of inflammation． Bi－variate correlation analysis showed that positive correlation was found between PCT and WBC and neutrophil（rs=0.609，P=0.000；rs=0.057，P=0.000） and there was correlation between PCT and hs-CRP（rs=0.213，P=0.020）． Conclusion：Serum PCT is a reliable mea－surement for the early diagnosis of urinary sepsis with high sensitivity and specificity and it is conducive to the early diagnosis and treatment of urinary sepsis.