血清降钙素原在血液透析导管相关性感染诊断中的应用价值
|
摘要
目的探讨血清降钙素原(PCT)在行血液透析置管引起的导管相关性感染诊断中的应用价值。方法采用免疫化学发光法检测导管相关性感染患者(75例)和非感染患者(400例)血清PCT和白细胞计数(WBC)水平,通过ROC曲线评价PCT和WBC指标对导管相关性感染的诊断价值。结果感染组患者血清PCT为(1.58±0.36)ng/ml,WBC水平为(7.53±0.67)×10~9/L,显著高于非感染组PCT为(0.11±0.08)ng/ml,WBC水平为(5.15±0.52)×10~9/L,差异具有统计学意义(P<0.05);ROC曲线分析显示,血清PCT和WBC的ROC曲线下面积(AUC)分别为0.845和0.512,并且PCT的AUC、诊断的敏感性(84.2%)及特异性(82.6%)均较WBC(敏感性:61.5%,特异性:30.7%)升高。结论血清PCT水平在血液透析导管相关性感染患者中明显升高,其对导管相关性感染的诊断具有较好的敏感性和特异性。
Objective To investigate application value of serum procalcitonin(PCT) in diagnosis of hemodialysis catheterization-induced catheter-related infection. Methods Immunochemistry luminescence method was applied to detect serum PCT and white blood cell count(WBC) levels in catheter-related infection patients(75 cases) and patients without infection(400 cases). Diagnostic value by PCT and WBC for catheterrelated infection was evaluated by ROC curve. Results The infection group had serum PCT as(1.58±0.36) ng/ml and WBC as(7.53±0.67)×10~9/L, which were obviously higher than PCT as(0.11±0.08) ng/ml and WBC as(5.15±0.52)×10~9/L in the non-infection group, and their difference had statistical significance(P<0.05). ROC curve analysis showed area under curve(AUC) of ROC respectively as 0.845 and 0.512 in serum PCR and WBC. PCT had all higher AUC, sensitivity(84.2%) and specificity(82.6%) in diagnosis than WBC(sensitivity as 61.5%, specificity as 30.7%). Conclusion High level of serum PCT is shown in patients with hemodialysis catheterrelated infection, and it provides excellent sensitivity and specificity in diagnosis of catheter-related infection.
Objective To investigate application value of serum procalcitonin(PCT) in diagnosis of hemodialysis catheterization-induced catheter-related infection. Methods Immunochemistry luminescence method was applied to detect serum PCT and white blood cell count(WBC) levels in catheter-related infection patients(75 cases) and patients without infection(400 cases). Diagnostic value by PCT and WBC for catheterrelated infection was evaluated by ROC curve. Results The infection group had serum PCT as(1.58±0.36) ng/ml and WBC as(7.53±0.67)×10~9/L, which were obviously higher than PCT as(0.11±0.08) ng/ml and WBC as(5.15±0.52)×10~9/L in the non-infection group, and their difference had statistical significance(P<0.05). ROC curve analysis showed area under curve(AUC) of ROC respectively as 0.845 and 0.512 in serum PCR and WBC. PCT had all higher AUC, sensitivity(84.2%) and specificity(82.6%) in diagnosis than WBC(sensitivity as 61.5%, specificity as 30.7%). Conclusion High level of serum PCT is shown in patients with hemodialysis catheterrelated infection, and it provides excellent sensitivity and specificity in diagnosis of catheter-related infection.
引文
[1]La GA,Biasucci DG,Pittiruti M,et al.Antimicrobial-coated catheters and catheter-over-guidewire exchange in patients with severe catheter-related bloodstream infection:Old procedure,new indications?American Journal of Infection Control,2016,44(5):616-617.
[2]郑勇.心胸外科中心静脉导管感染患者的相关因素分析及预防对策.中国实用医药,2014,9(22):236-237.
[3]谭熙,李贱,梁宗安,等.降钙素原与C反应蛋白对老年社区获得性肺炎患者的早期诊断价值.西部医学,2015,27(12):1803-1805.
[4]邹鹤娟,李光辉.血管内导管相关感染诊断和处理临床指南:美国感染病学会2009年更新.中国感染与化疗杂志,2010,10(2):81-84.
[5]Martínez-Morel HR,Sanchez-PayáJ,García-Shimizu P,et al.Effectiveness of a programme to reduce the burden of catheterrelated bloodstream infections in a tertiary hospital.Epidemiol Infect,2016,144(9):2011-2017.
[6]Chakravarti SB,Reformina DA,Lee TM,et al.Procalcitonin as a biomarker of bacterial infection in pediatric patients after congenital heart surgery.Annals of Pediatric Cardiology,2016,9(2):115-119.
[7]游东,刘强,梁光彬,等.糖尿病足感染患者中血清降钙素原与血清超敏C-反应蛋白水平变化的临床评价.现代医学,2015(8):1060-1063.
[8]梁浩凡,钟林滔,程海兵,等.动态监测降钙素原水平在急性胰腺炎病程判断及抗生素应用中的价值分析.中国当代医药,2015,22(34):28-30.
[9]Boersma RS,Hamulyak K,van Oerle R,et al.Biomarkers for Prediction of Central Venous Catheter Related-Thrombosis in Patients With Hematological Malignancies.Clin Appl Thromb Hemost,2016,22(8):779-784.
[10]马立彬,邓刚,王本勇,等.血清降钙素原对血液透析患者导管相关性感染的诊断价值.中华医院感染学杂志,2014,24(4):1033-1035.
[11]刘小平,张桂玉.血清降钙素原水平测定对血液透析中心静脉留置导管相关性血流感染的诊断价值.河北联合大学学报(医学版),2015,17(6):202-204.
[12]庞玉洪,赵建明,陈抗侵,等.血清降钙素原联合C反应蛋白对血液透析导管相关性感染的早期诊断价值.医学研究杂志,2016,45(7):85-87.
[13]马立彬,邓刚,王鸣,等.降钙素原在颈内静脉导管相关性感染诊断和治疗中的应用.中华肾脏病杂志,2014,30(3):229-230.
[14]林华,郑瑞强,吴晓燕,等.血清降钙素原在导管相关血流感染早期诊断中的价值.临床医药文献电子杂志,2015(33):6764-6765.
[15]倪菊平,姜丽静,沈国锋,等.血清降钙素原在导管相关性血流感染诊断及预后评估中的价.中华实用诊断与治疗杂志,2015,29(1):56-58.
[16]王芳,潘淼,李大勇,等.降钙素原在血液透析患者导管相关性血行感染中的应用价值.中国血液净化,2013,12(2):74-77.
[17]郭鹏威,王洁,林栩,等.血清降钙素原在诊断血液透析病人感染中价值的探讨.右江医学,2014,42(4):439-441.
[18]黄赞鸿,郑康鑫,邱潮锋.血清降钙素原检测在感染性疾病诊治中的应用价值.中国校医,2014,28(12):908-910.
[19]丁士新.降钙素原诊断临时性血液透析中心静脉留置导管相关性血流感染价值.中华实用诊断与治疗杂志,2013,27(10):1014-1015.
[20]刘巍,彭子琪.血清降钙素原在肺部感染诊断中临床的价值.药物与人,2014(12):109.
[2]郑勇.心胸外科中心静脉导管感染患者的相关因素分析及预防对策.中国实用医药,2014,9(22):236-237.
[3]谭熙,李贱,梁宗安,等.降钙素原与C反应蛋白对老年社区获得性肺炎患者的早期诊断价值.西部医学,2015,27(12):1803-1805.
[4]邹鹤娟,李光辉.血管内导管相关感染诊断和处理临床指南:美国感染病学会2009年更新.中国感染与化疗杂志,2010,10(2):81-84.
[5]Martínez-Morel HR,Sanchez-PayáJ,García-Shimizu P,et al.Effectiveness of a programme to reduce the burden of catheterrelated bloodstream infections in a tertiary hospital.Epidemiol Infect,2016,144(9):2011-2017.
[6]Chakravarti SB,Reformina DA,Lee TM,et al.Procalcitonin as a biomarker of bacterial infection in pediatric patients after congenital heart surgery.Annals of Pediatric Cardiology,2016,9(2):115-119.
[7]游东,刘强,梁光彬,等.糖尿病足感染患者中血清降钙素原与血清超敏C-反应蛋白水平变化的临床评价.现代医学,2015(8):1060-1063.
[8]梁浩凡,钟林滔,程海兵,等.动态监测降钙素原水平在急性胰腺炎病程判断及抗生素应用中的价值分析.中国当代医药,2015,22(34):28-30.
[9]Boersma RS,Hamulyak K,van Oerle R,et al.Biomarkers for Prediction of Central Venous Catheter Related-Thrombosis in Patients With Hematological Malignancies.Clin Appl Thromb Hemost,2016,22(8):779-784.
[10]马立彬,邓刚,王本勇,等.血清降钙素原对血液透析患者导管相关性感染的诊断价值.中华医院感染学杂志,2014,24(4):1033-1035.
[11]刘小平,张桂玉.血清降钙素原水平测定对血液透析中心静脉留置导管相关性血流感染的诊断价值.河北联合大学学报(医学版),2015,17(6):202-204.
[12]庞玉洪,赵建明,陈抗侵,等.血清降钙素原联合C反应蛋白对血液透析导管相关性感染的早期诊断价值.医学研究杂志,2016,45(7):85-87.
[13]马立彬,邓刚,王鸣,等.降钙素原在颈内静脉导管相关性感染诊断和治疗中的应用.中华肾脏病杂志,2014,30(3):229-230.
[14]林华,郑瑞强,吴晓燕,等.血清降钙素原在导管相关血流感染早期诊断中的价值.临床医药文献电子杂志,2015(33):6764-6765.
[15]倪菊平,姜丽静,沈国锋,等.血清降钙素原在导管相关性血流感染诊断及预后评估中的价.中华实用诊断与治疗杂志,2015,29(1):56-58.
[16]王芳,潘淼,李大勇,等.降钙素原在血液透析患者导管相关性血行感染中的应用价值.中国血液净化,2013,12(2):74-77.
[17]郭鹏威,王洁,林栩,等.血清降钙素原在诊断血液透析病人感染中价值的探讨.右江医学,2014,42(4):439-441.
[18]黄赞鸿,郑康鑫,邱潮锋.血清降钙素原检测在感染性疾病诊治中的应用价值.中国校医,2014,28(12):908-910.
[19]丁士新.降钙素原诊断临时性血液透析中心静脉留置导管相关性血流感染价值.中华实用诊断与治疗杂志,2013,27(10):1014-1015.
[20]刘巍,彭子琪.血清降钙素原在肺部感染诊断中临床的价值.药物与人,2014(12):109.