[1]廖悦婷,杨芳年,王小燕,等.降钙素原和C反应蛋白在重症病房脓毒血症患者早期诊断中的应用价值[J].福建医药杂志,2023,45(03):19-22.
　LIAO Yueting,YANG Fangnian,WANG Xiaoyan,et al.Application value of procalcitonin and C-reactive protein in the early diagnosis of sepsis patients in intensive care unit[J].FUJIAN MEDICAL JOURNAL,2023,45(03):19-22.
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降钙素原和C反应蛋白在重症病房脓毒血症患者早期诊断中的应用价值()
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《福建医药杂志》[ISSN:1002-2600/CN:35-1071/R]

卷:
45
期数:
2023年03期
页码:
19-22
栏目:
临床研究
出版日期:
2023-06-15

文章信息/Info

Title:
Application value of procalcitonin and C-reactive protein in the early diagnosis of sepsis patients in intensive care unit
文章编号:
1002-2600(2023)03-0019-04
作者:
廖悦婷; 杨芳年; 王小燕1; 郭玉嵩2
厦门大学附属中山医院临床输血科(厦门 361004)
Author(s):
LIAO Yueting;  YANG Fangnian;  WANG Xiaoyan;  GUO Yusong
Department of Blood Transfusion, Zhongshan Hospital Affiliated to Xiamen University, Xiamen, Fujian 361004, China
关键词:
降钙素原;  C反应蛋白;  脓毒血症;  病原菌;  革兰阴性菌;  革兰阳性菌
Keywords:
procalcitonin;  C-reactive protein;  sepsis;  pathogens;  Gram-negative bacteria;  Gram-positive bacteria
分类号:
R446.1
文献标志码:
B
摘要:
目的 探讨降钙素原(PCT)和C反应蛋白(CRP)在重症病房脓毒血症患者早期诊断中的应用价值。方法 选取2020年1月至2022年2月我院ICU收治的165例脓毒血症患者,分析病原菌的分布,比较革兰阴性菌感染者和革兰阳性菌感染者的临床指标差异,分析各临床指标对区分革兰阴性菌感染者和革兰阳性菌感染者的灵敏度和特异度以及相互间的相关性。数据采用GraphPad软件进行显著性差异和ROC曲线分析,Spearman秩相关法进行相关性分析。结果 165例患者共检出212株病原菌,革兰阴性菌占48.59%,革兰阳性菌占42.45%,真菌占8.96%; 绝大部分患者的PCT和CRP水平均高于正常范围,PCT、CRP水平在革兰阴性感染组和革兰阳性感染组间差异有统计学意义(P<0.05),且两者呈正相关(r>0.3),革兰阴性菌感染者的PCT和CRP平均水平显著高于革兰阳性菌感染者; PCT水平高于(28.42±38.87)ng/mL时感染革兰阴性菌概率高,同时,CRP水平高于(148.29±91.45)mg/L时感染菌较可能为常见的肺炎克雷伯菌、大肠埃希菌或鲍曼不动杆菌的其中一种。结论 PCT和CRP对脓毒血症的早期诊断具有重要价值,高水平的PCT和CRP有助于临床医生对疑似脓毒血症患者进行及时决策并指导抗菌药物的合理使用。
Abstract:
Objective To explore the application value of procalcitonin(PCT)and C-reactive protein(CRP)in the early diagnosis of patients with sepsis in intensive care unit(ICU). Methods A total of 165 patients with sepsis admitted to our hospital from January 2020 to February 2022 were enrolled,the clinical parameters between the patients with Gram-negative bacteria and those with Gram-positive bacteria were compared, and the correlation between various clinical parameters was evaluated. The data were analyzed by using GraphPad software for ROC curves and significant difference analysis and Spearman method for correlation analysis. Results A total of 212 pathogenic bacteria were detected in 165 patients: 48.59% were Gram-negative bacteria, 42.45% were Gram-positive bacteria, and 8.96% were fungi; the levels of PCT and CRP in the vast majority of patients were abnormally high, and the levels of PCT and CRP were significantly different between the Gram-negative group and the Gram-positive group(P<0.05), and the levels of PCT and CRP were positively correlated(r>0.3).The mean levels of PCT and CRP in patients with Gram-negative bacteria were significantly higher than those with Gram-positive bacteria.When PCT level was higher than(28.42±38.87)ng/mL, the probability of infection with Gram-negative bacteria was high. And at the same time, when the CRP level was higher than(148.29±91.45)mg/L,the infected bacteria might be one of Klebsiella pneumoniae, Escherichia coli or Acinetobacter baumannii. Conclusion PCT and CRP may be used for diagnosis of sepsis. A high level of PCT and CRP can help clinicians make timely decisions to use antibiotics appropriately in patients with suspected sepsis.

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备注/Memo

备注/Memo:
1 厦门大学附属中山医院药学部; 2 通信作者,Email:ysguo_xmdoc@hotmail.com
更新日期/Last Update: 2023-06-15