| 王环君，皮银珍，杨腾舜，刘罗坤.降钙素原对2型糖尿病败血症的临床价值.[J].中南医学科学杂志.,2015,43(6):692-695. |
| 降钙素原对2型糖尿病败血症的临床价值 |
| The Clinical Significance of PCT in Type 2 Diabtetic Mellitus with Septicemia |
| 投稿时间：2015-06-23 |
| DOI： |
| 中文关键词: 糖尿病 败血症 降钙素原 |
| 英文关键词:type 2 diabetic mellitus septicemia PCT |
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| 中文摘要: |
| 目的 探讨降钙素原（PCT）对2型糖尿病败血症的临床意义。方法 对2012年9月至2014年9月的92例入院时或入院后发热、疑似败血症的2型糖尿病患者，根据血培养结果分为败血症组和非败血症组，其中败血症组49例（G-菌34例、G+菌15例），非败血症组43例，比较两组间PCT的表达水平、糖尿病败血症组中G+菌以及G-菌PCT的表达水平、及PCT与CRP对糖尿病败血症诊断的差异。结果 在92例发热的糖尿病患者中，糖尿病败血症组PCT表达水平明显高于糖尿病非败血症组（P<0.01），糖尿病败血症组患者以G-菌感染为主，且G-菌患者中PCT表达水平高于G+菌组（P<0.05）；G-菌主要以大肠埃细菌感染为主（占24.49%）；G+菌感染主要为凝固酶阴性葡萄球菌为主（占12.24%）。与传统的感染性指标CRP相比，糖尿病败血症组中PCT的AUC为0.98（95%CI:0.96～1.0），高于CRP（AUC 0.81，95%CI:0.73～0.90）。当cutoff值为8 nd/mL时，糖尿病患者中PCT诊断败血症的敏感性为85.7%，特异性为98.0%。结论 PCT水平在2型糖尿病败血症患者中早期即有显著升高，以G-菌中升高更明显，对败血症的预测价值高于CRP。 |
| 英文摘要: |
| Objective To investigate the clinical significance of PCT in type 2 diabetes mellitus with septicemia. Methods The data were collected from 92 cases of type 2 diabetic patients，who had fever and were suspected infectioned by the septicemia.Among the patients with positive blood culture，there were 15 cases with Gram-positive bacteria cultured positive and 34 cases with gram-negative bacteria cultured positive.The aim was to compare the expression levels of PCT in septicemic patients with type 2 diabetic mellitus and non-septicemic group，the expression levels of PCT in gram-negative bacteria and gram-positive bacteria septicemia and the different significance of PCT and CRP in septicemia group. Results The expression of PCT in septicemia patients was significantly higher than in non-septicemic group（P<0.01） among 92 type 2 diabetic patients with fever，and higher in gram-negative bacteria infection group than the gram-positive one.The Escherichia coli was the predominant species in gram-negative bacteria group causing the septicemia，accounting for 24.49%，and the coagulase negative staphylococcus was dominant among the gram-positive bacteria sepsis，accounting for 12.24%.The AUCs of PCT，CRP were 0.98（95%CI:0.96-1.0），0.81（95%CI:0.73-0.90）.Using 8 nd/mL as the best cutoff，the sensitivity of PCT was 85.7% and specificity was 98.0% for type 2 diabetic mellitus with septiceia. Conclusion The level of PCT was significantly higher in type 2 diabetic mellitus with septicemia than the non-septicemia early，more significantly higher in gram-negative bacteria infection group than the gram-positive one，whose predicted value was higher than CRP. |
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