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1、PCT和CRP在败血症、SIRS和系统性念珠菌感染屮的诊断作用ProcalcitoninandC-reactiveproteininthediagnosisofbacterialsepsis,SIRSandsystemiccandidiasis目的评价PCT、C反应蛋O(C-reactiveprotein,CRP)、血小板(PLT)和乳酸脱氢酶(LDH)对ICU患者败血症、SIRS和系统性念珠菌感染的早期诊断意义。方法选择我院150例ICU患者，根据血培养结果,将其分成三组，其屮败血症73人,SIRS44人，系统性念珠菌感染33
2、人，在其败血症发作时第0天和笫2天采集血液检测PCT、CRP、LDH和PLT,收集数据然后进行统计学分析。结果苹兰阴性细菌性感染屮PCT明显高于苹兰阳性菌感染，但无显著性差异(P=0.095)o细菌性败血症组PCT、CRP、PLT和LDH明显高于系统性念珠菌感染组。PCT的AUC(AUC:0.892,PvO.OOl)高于CRP(AUC:0.73&P<0.001)。PCT和CRP的cutoff值分别为0.99ng/mL和76.2mg/LoPCT的灵敏度和特异性分别为84.3%和81.8%,而CRP灵敏度和特异性分别为77.2%和6
3、3.6%。然而PCT不足以区别SIRS和系统性念珠菌感染(P=0.093).结论PCT可作为系统性念珠菌感染的早期诊断指标，但当其<0.99ng/mL时不能区别念珠菌感染和SIRS,需结合其他真菌感染指标來诊断系统性念珠菌感染。关键词：PCT,败血症，系统性念珠菌感染，LDHAbstractObjectiveToevaluateprocalcitonin(PCT),C-reactiveprotein(CRP),plateletcount(PLT)andserumlactatedehydrogenase(LDH)asearlyma
4、rkersfordiagnosisofSIRS,bacterialsepsisandsystemiccandidiasisinintensivecareunit(ICU)patients.MethodsBasedonbloodcultureresults,thepatientsweredividedintoasepsisgroup(73patients),aSIRSgroup(44patients)andasystemiccandidiasisgroup(33patients).PCT,CRP,LDHandPLTlevelswe
5、remeasuredonday0andonday2fromthesepsissymptomonset.Thedatawerecollectedandanalyzedstatistically.ResultsPCTlevelswerehigherinGramnegativesepsisthanthoseinGrampositivesepsis,althoughtheP-valuebetweenthetwosubgroupsisnotsignificant(P=0.095).Bacterialsepsisgrouphadhigher
6、PCT,CRP,PLTandLDHlevelscomparedwiththesystemiccandidiasisgroup・TheAUCforPCT(AUC:0.892,P<0.001)waslargerthanforCRP(AUC:0.738,P<0.001).ThebestcutoffvaluesforPCTandCRPwere0.99ng/mLand76.2mg/L,respectively.DiagnosticsensitivityandspecificityforPCTwere84.3%and81.8%whereas
7、CRPshowedasensitivityof77.2%andaspecificityof63.6%・However,PCTwasunabletodiscriminatebetweenSIRSandsystemiccandidiasisgroups(P=0・093)・ConclusionsPCTcanbeusedasapreliminarymarkerintheeventofclinicalsuspicionofsystemiccandidiasis;howeverjowPCTlevels(<0.99ng/mL)necessar
8、ilyrequiretheuseofotherspecificmarkersofcandidaemiatoconfirmthediagnosis,duetogreatuniformityofPCTlevelsinsystemiccandidiasisandSIR
