Clinical value of procalcitonin for patients with suspected bloodstream infection.
对疑似血液感染的患者进行降钙素原测定的临床价值。
Hattori T,Nishiyama H,Kato H,Ikegami S,Nagayama M,Asami S,Usami M,Suzuki M,Murakami I,Minoshima M,Yamagishi H,Yuasa N
Abstract
Objectives: Procalcitonin (PCT) might be a useful marker to exclude bacteremia or to predict the severity of bacteremia and its outcome. However, most previous studies of PCT were limited to particular patient populations. In addition, reports about PCT levels in patients with renal dysfunction have been conflicting. We investigated the predictive value of PCT in an unselected population with suspected bloodstream infections and also assessed the relationship between PCT and renal function. Methods: We retrospectively analyzed medical records of 1,331 patients (age ≥1 8 years) with suspected bloodstream infections who had concurrent biochemical data and blood culture results. Results: The PCT level was significantly elevated in patients with positive blood cultures, and it showed a significant relation with survival in patients with bacteremia. The optimal cutoff value of PCT for predicting a positive blood culture showed an increase as the estimated glomerular filtration rate declined. Conclusion: PCT can be a useful marker to exclude bacteremia and also to predict severe bacteremia, but renal function should be taken into account.
摘要
目的:在排除菌血症或预测菌血症的严重程度及预后的方面,降钙素原(PCT)可能是一种有用的标记。然而,此前大部分对PCT的研究受到特殊患者数量的限制。另外,关于肾功能不全患者PCT水平的报道还存在争议。在未经选择的疑似血液感染患者中我们调查了PCT的预测价值,同时也评估了PCT和肾功能水平的关系。方法:我们对1331例有同期生化数据和血培养结果的疑似血液感染患者的病历记录进行回顾性分析。结果:血培养阳性患者的PCT水平显著升高,这表明PCT与菌血症患者的生存有明显关系。在预测血培养阳性时,随着肾小球滤过率降低,PCT的最佳阈值升高。结论:在排除菌血症和预测重症菌血症的方面,PCT可能是一种有用的标记,但是肾功能水平应该被考虑在内。
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