降钙素原对感染性心内膜炎的预后判断价值

doi:10.3969/j.issn.1673-8640.2016.04.001

摘要/Abstract

摘要：

目的分析血清降钙素原（PCT）对感染性心内膜炎（IE）的预后判断价值。方法选择80例IE患者,将出现不良预后（严重并发症或死亡）的IE患者作为IE不良预后组,未出现并发症的IE患者作为IE无并发症组。采用酶联荧光分析法检测2个组患者血清PCT,免疫比浊法检测C反应蛋白(CRP)。将2个组患者的PCT和CRP水平进行比较,并比较PCT与CRP判断IE不良预后的敏感性、特异性、阳性预测值和阴性预测值。结果IE不良预后组PCT、CRP水平和阳性率均高于IE无并发症组（P<0.05）。PCT对IE不良预后的诊断敏感性、特异性、阳性预测值、阴性预测值与CRP相比,差异无统计学意义（P>0.05）。结论实施血清PCT水平的监测对IE的预后判断具有重要的临床价值,有条件时应联合检测CRP。

关键词: 降钙素原, C反应蛋白, 感染性心内膜炎

Abstract:

Objective To analyze the significance of serum procalcitonin （PCT） for the prognosis of infective endocarditis（IE）. Methods A total of 80 patients with IE were enrolled. IE patients with poor prognosis （severe complications or death） were as poor prognosis group,and IE patients without complications were as no complication group. Serum PCT of the 2 groups were determined by enzyme-linked fluorescence analysis,and C-reactive protein（CRP） was analyzed by nephelometry immunoassay. The levels of PCT and CRP were compared between the 2 groups. The sensitivities, specificities,positive predictive values and negative predictive values of PCT and CRP for judging IE poor prognosis were compared. Results PCT and CRP in poor prognosis group had higher levels and positive rates than those in no complication group（P<0.05）. The sensitivity, specificity, positive predictive value and negative predictive value of PCT for IE poor prognosis diagnosis had no statistical significance compared with CRP （P>0.05）. Conclusions Monitoring serum PCT is of important significance for the prognosis diagnosis of IE,which should be combined with CRP determination when available.

Key words: Procalcitonin, C-reactive protein, Infective endocarditis

中图分类号:

R446.62

张海霞, 杜刚, 许海峰, 杨桂英, 刘亚君, 彭静, 于冲, 彭琼英. 降钙素原对感染性心内膜炎的预后判断价值[J]. 检验医学, 2016, 31(4): 243-246.

ZHANG Haixia, DU Gang, XU Haifeng, YANG Guiying, LIU Yajun, PENG Jing, YU Chong, PENG Qiongying. Serum procalcitonin in diagnosing prognosis of infective endocarditis[J]. Laboratory Medicine, 2016, 31(4): 243-246.

图/表 3

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组别	例数	PCT（ng/mL）	CRP（mg/L）
IE不良预后组	43	4.01±3.69^*	65.1±4.6^*
IE无并发症组	37	0.64±0.58	42.5±13.6

组别	例数	PCT（ng/mL）	CRP（mg/L）
IE不良预后组	43	4.01±3.69^*	65.1±4.6^*
IE无并发症组	37	0.64±0.58	42.5±13.6

组别	例数	PCT		CRP
组别	例数	阳性	阴性	阳性	阴性
IE不良预后组	43	32（74.4）	11（25.6）	31（72.1）	12（27.9）
IE无并发症组	37	11（29.7）	26（70.3）	13（31.1）	24（64.9）
χ²值		15.977		10.975
P值		< 0.05		< 0.05

组别	例数	PCT		CRP
组别	例数	阳性	阴性	阳性	阴性
IE不良预后组	43	32（74.4）	11（25.6）	31（72.1）	12（27.9）
IE无并发症组	37	11（29.7）	26（70.3）	13（31.1）	24（64.9）
χ²值		15.977		10.975
P值		< 0.05		< 0.05

指标	敏感性	特异性	阳性预测值	阴性预测值
PCT	74.4（32/43）	70.3（26/37）	74.4（32/43）	70.3（26/37）
CRP	72.1（31/43）	64.9（24/37）	70.5（31/44）	66.7（24/36）