检验医学 ›› 2021, Vol. 36 ›› Issue (12): 1215-1218.DOI: 10.3969/j.issn.1673-8640.2021.012.004

• 临床应用研究·论著 • 上一篇    下一篇

不同脓毒症诊断标准中降钙素原的临床意义

潘锡龙1, 徐志远2, 谢锋3, 李丹1   

  1. 1.中山市东升医院检验科,广东 中山 528414
    2.中山市东升医院重症医学科,广东 中山 528414
    3.中山市东升医院内科,广东 中山 528414
  • 收稿日期:2020-08-08 出版日期:2021-12-30 发布日期:2021-12-29
  • 作者简介:潘锡龙,男,1980年生,学士,副主任技师,主要从事实验室质量管理工作。

Role of procalcitonin in the diagnosis of different sepsis

PAN Xilong1, XU Zhiyuan2, XIE Feng3, LI Dan1   

  1. 1. Department of Clinical Laboratory,Dongsheng Hospital of Zhongshan City,Zhongshan 528414,Guangdong,China
    2. Department of Critical Care Medicine,Dongsheng Hospital of Zhongshan City,Zhongshan 528414,Guangdong,China
    3. Department of Internal Medicine,Dongsheng Hospital of Zhongshan City,Zhongshan 528414,Guangdong,China
  • Received:2020-08-08 Online:2021-12-30 Published:2021-12-29

摘要:

目的 明确降钙素原(PCT)在脓毒症诊断标准由Sepsis-1变为Sepsis-3时,诊断效能的差异,为临床诊断脓毒症提供参考。方法 选取189例有感染或/和全身炎症反应综合征(SIRS)表现的患者,并根据病情将其分为脓毒症组、非脓毒症组、脓毒性休克组,以30名健康体检者作为对照组,检测所有研究对象PCT水平。采用受试者工作特征(ROC)曲线评价采用Sepsis-1和Sepsis-3标准时PCT诊断脓毒症的效能。结果 不同诊断标准中,对照组、非脓毒症组、脓毒症组、脓毒性休克组PCT水平呈逐渐上升趋势(P<0.05)。采用Sepsis-1和Sepsis-3诊断标准,PCT诊断脓毒症的曲线下面积分别为0.85、0.73,敏感性分别为76.85%和57.01%,特异性分别为78.38%和76.79%;PCT诊断脓毒性休克中的曲线下面积分别为0.75、0.76,敏感性分别为73.91%、64.86%,特异性分别为80.65%和81.43%。结论 脓毒症诊断标准由Sepsis-1变为Sepsis-3,PCT的诊断效能有所下降,但对脓毒性休克的诊断效能无变化。

关键词: 降钙素原, 脓毒症, Sepsis-1, Sepsis-3

Abstract:

Objective To investigate the specific changes in the diagnostic efficacy of procalcitonin(PCT) when the diagnostic criteria for sepsis changed from Sepsis-1 to Sepsis-3,and to provide a reference for the clinical application of PCT in the diagnosis of sepsis. Methods A total of 189 patients with infection or(and) the manifestations of systemic inflammatory response syndrome(SIRS)(non-sepsis,sepsis and septic shock groups) and 30 healthy subjects(healthy control group)were enrolled. PCT was determined in all the subjects. Receiver operating characteristic(ROC) curves were used to evaluate the roles of Sepsis-1 and Sepsis-3 for the diagnosis of PCT. Results There was an increasing trend in PCT levels from healthy control,non-sepsis,sepsis to septic shock groups in each diagnostic component(P<0.05). Based on Sepsis-1 and Sepsis-3 diagnostic criteria,the areas under curves were 0.85 and 0.73,the sensitivities were 76.85% and 57.01%,the specificities were 78.38% and 76.79%,respectively. The areas under curves,sensitivities and specificities of PCT in the diagnosis of septic shock were 0.75 and 0.76,73.91% and 64.86%,80.65% and 81.43%,respectively. Conclusions When the diagnostic criteria for sepsis change from Sepsis-1 to Sepsis-3,the diagnostic efficacy of PCT decreases in the diagnosis of sepsis,and the diagnostic efficacy of PCT does not change in the diagnosis of septic shock.

Key words: Procalcitonin, Sepsis, Sepsis-1, Sepsis-3

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