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1、血清降钙素原检测在细菌性感染疾病早期诊断中的临床应用【摘要】目的探讨血清降钙素原（PCT）检测在细菌性感染疾病早期诊断中的临床应用价值。方法选取347例感染性疾病患者为研究对象，根据病原学和血清免疫学确诊实验分为细菌性感染组（212例）和病毒性感染组（135例）。采用ATB细菌鉴定分析系统进行细菌培养及鉴定；采用乳胶增强免疫散射比浊法在罗氏CobasE411型全口动电化学发光免疫分析仪上测定血清PCT和C反应蛋白（CRP）水平；统计对比分析各组指标的检测结果。结果细菌性感染组中，PCT检测结果阳性率为86.79%,明显高于病毒性感染组的6.67
2、%（x2=214.519,P<0.001）,且与细菌培养结果比较差异无统计学意义（x2二0.125,P=0.724）oROC曲线分析结果显示,CRP、PCT、WBC及ESR的ROC曲线下面积分别为0.805、0.912、0.787和0.673,标准误（s）分别为0.050、0.053、0.041和0.028,95%置信区间分别为0.731〜0.892、0.877〜0.964、0.693—0.835和0.612〜0.763。结论PCT不仅可以作为早期诊断细菌性感染的特异性指标，还可用于细菌性感染与病毒性感染的鉴别诊断，同时动态监测PCT水平变化对
3、治疗细菌性感染也有一定的指导作用，值得临床推广应用。【关键词】降钙素原；感染性疾病；细菌感染；病毒感染[Abstract】ObjectiveToinvestigatetheclinicalvalueofdetectionofscrumprocalcitonin(PCT)inearlydiagnosisofbacterialinfection.MethodsAtotalof347patientswithinfectiousdiseaseswereselectedasresearchobjects,anddividedintobacterialin
4、fectiongroup(n=212)andviralinfectiongroup(n=135)・BacterialcultureandidentificationworecarriedoutbyATBbacterialidentificationandanalysissystem.TheserumlevelsofPCTandC~reactiveprotein(CRP)weremeasuredbylatexenhancedimmunescatteringturbidimetryonRocheCobasE411automatedelectroch
5、em订uminescenceimmunoassayinstrument・Inaddition,SPSS13statisticalsoftwarewasadoptedtocompareandanalyzethetestresultsofeachgroup.ResultsInthebacterialinfectiongroup,thepositiverateofPCTtestwas86.79%,whichwashigherthanthat(6.67%)ofviralinfectiongroup(x2=214.519,P〈0・001),andcomp
6、aredwithbacterialcultureresults,differencewasnotstatisticallysignificant(x2=0.125,P=0.724)・ROCcurveanalysisresultsalsoshowedthattheareaofROCcurveofCRP,PCT,WBCandESRwererespectively0.805,0.912,0.787and0.673,standarderror(s)wererespectively0.050,0.053,0.041and0.028,and95%confi
7、denceintervalswererespectively0.731~0.892,0.877~0.964,0.693〜0.835and0.612~0.763.ConclusionPCTcannotonlybeusedasaspecificmarkerforearlydiagnosisofbacterialinfection,butalsofordifferentidldiagnosisofbacterialinfectionandviralinfection.AnddynamicmonitoringofthelevelsofPCTchange
8、salsomakecertainguidanceforthetreatmentofbacterialinfection,andthusitiswort
