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降钙素原对慢性肾脏病5期患者感染的预测价值
作者:孙妍蓓1  蒋丽娟2  邵小南3 
单位:1. 苏州大学附属第三医院 肾脏科, 江苏 常州 213003;
2. 苏州大学附属第三医院 检验科, 江苏 常州 213003;
3. 苏州大学附属第三医院 核医学科, 江苏 常州 213003
关键词:慢性肾脏病 降钙素原 感染 脓毒症 
分类号:R692
出版年·卷·期(页码):2018·37·第四期(553-559)
摘要:

目的:探讨降钙素原(PCT)对慢性肾脏病(CKD)5期患者感染的预测价值。方法:将苏州大学附属第三医院肾脏科住院的373例CKD 5期患者分为非感染组、局部感染组和脓毒症组,另选择75例健康成人作为对照组,比较各组临床特点和炎症指标。结果:在CKD 5期,基线PCT、中性粒细胞比例明显高于对照组(均P<0.001)。白细胞计数(WBC)和中性粒细胞比例无法预测局部感染(均P>0.05),PCT和C-反应蛋白(CRP)预测局部感染的ROC曲线下面积(AUC)分别为0.715、0.780,均P<0.05。CRP和WBC无法预测脓毒症(均P>0.05);PCT和中性粒细胞比例预测脓毒症的AUC分别为0.823、0.683,均P<0.05。结论:CKD 5期患者的PCT和中性粒细胞比例水平明显升高;PCT预测局部感染的价值不如CRP,而预测脓毒症价值最优。

Objective:To investigate the predictive value of procalcitonin (PCT) in infection in patients with stage 5 chronic kidney disease. Methods:A total of 373 cases of stage 5 CKD patients who were hospitalized from Department of Nephrology, the Third Affiliated Hospital of Suzhou University were retrospectively analyzed. The patients were divided into non-infected group, local infection group and sepsis group. 75 healthy people were selected as the control group. The clinical characteristics and inflammatory parameters were compared. Results:The baseline PCT and neutrophil percentage in patients with stage 5 CKD were significantly higher than those in the control group (all P<0.001). In patients with stage 5 CKD, WBC and neutrophil percentage could not predict local infection (P> 0.05). The AUC of PCT and CRP were 0.715 (P<0.001) and 0.780(P<0.001) for local infection, respectively. CRP and WBC were unable to predict sepsis in patients with stage 5 CKD (P>0.05). The AUC of PCT and neutrophil percentage were 0.823 (P<0.001) and 0.683 (P<0.001) for sepsis, respectively. Conclusion:Compared with other inflammatory markers, the baseline PCT and neutrophil percentage in patients with stage 5 CKD are significantly higher. In stage 5 CKD phase, the ability of PCT to predict local infection is less than that of CRP, whereas PCT can best predict sepsis.

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