标题：心力衰竭并发感染患者血清降钙素原检测的临床价值

      作者：王若琪 1，张雅 1，牛诗雯 2
    (1.北京市仁和医院检验科，北京 102600；
2.北京朝阳医院西院检验科，北京 100043)

      卷次： 2016年27卷13期

      【摘要】 目的 探讨血清降钙素原(PCT)检测对心力衰竭患者发生感染的诊断价值。方法 选取2014年8月
至2015年8月在我院接受治疗的不同程度心力衰竭患者300例，将186例合并感染的患者作为观察组，114例未发
生感染的患者作为对照组，分析两组患者的PCT水平，另选择健康体检者 75例作为健康组。 结果 观察组患者
的 PCT水平为(19.33±5.71) μg/L，明显高于对照组的(4.92±0.97) μg/L和健康组的(4.35±0.89) μg/L，差异均具有统
计学意义 (P<0.05)；观察组Ⅱ、Ⅲ、Ⅳ级心衰敏感性和特异度分别为 67.28%/64.19%、76.94%/73.77%、89.63%/
85.32%，也明显高于对照组的 53.12%/42.37%；PCT的阴性预测值随心衰级别的升高而增加，观察组Ⅱ、Ⅲ、Ⅳ级
心衰 PCT的阴性预测值分别为 39.74%、52.18%、90.06%，阳性预测值则相反，观察组Ⅱ、Ⅲ、Ⅳ级心衰 PCT阳性
预测值分别为 88.28%、79.15%、64.20%；心衰级别越高，两组患者的 PCT水平也随之增高，Ⅱ、Ⅲ、Ⅳ级心衰的
PCT水平分别为(5.52±1.21) μg/L、(12.33±3.76) μg/L、(21.39±6.80) μg/L；以上各项指标比较差异均具有统计学意
义(P<0.05)。结论 血清PCT的高表达与心力衰竭患者发生感染密切相关，具有一定的临床应用价值。

      【关键词】 血清降钙素原；心力衰竭；感染；诊断价值

      【中图分类号】 R541.6 【文献标识码】 A 【文章编号】 1003—6350（2016）13—2113—03


Clinical value of serum procalcitonin detection in patients with heart failure complicated by infection.
WANG
Ruo-qi 1, ZHANG Ya 1, NIU Shi-wen 2. 1. Department of Clinical Laboratory, the Renhe Hospital of Beijing Municipality,
Beijing 102600, CHINA; 2. Department of Clinical Laboratory, the Chaoyang Hospital West Hospital of Beijing, Beijing
100043, CHINA

【Abstract】 Objective To evaluate the diagnostic value of serum procalcitonin (PCT) in patients with heart fail-
ure complicated by infection. Methods A total of 300 patients with heart failure, who admitted to our hospital from Au-
gust 2014 to August 2015, were selected as research subjects and divided into observation group (186 patients complicat-
ed by infection) and control group (114 patients without infection). The PCT levels of two groups were analyzed, and 75
healthy cases were also evaluated as health group at the same time. Results The PCT levels in observation group
[(19.33±5.71) μg/L] was significantly higher than that in control group [(4.92±0.97) μg/L] and health group [(4.35±
0.89) μg/L] (P<0.05). The sensitivity and specificity inⅡ,Ⅲ,Ⅳ stage of observation group (67.28%/64.19%, 76.94%/
73.77%, 89.63%/85.32 %) were also significantly higher than the control group (53.12%/42.37%). Negative predictive val-
ue of PCT increased as heart failure level rise, the negative predictive values of PCT in Ⅱ, Ⅲ, Ⅳ stage in observation
group were respectively 39.74%, 52.18%, 90.06%. In contract, the positive predictive values of PCT inⅡ,Ⅲ,Ⅳ stage in
observation group were respectively were 88.28%, 79.15%, 64.20 %. The higher level of heart failure, the more increase
of PCT levels in the two groups, the heart failure PCT level in Ⅱ, Ⅲ, Ⅳ stage were respectively (5.52 ± 1.21) μg/L,
(12.33±3.76) μg/L, (21.39±6.80) μg/L. All above differences were statistically significant (P<0.05). Conclusion Heart
failure patients with the high expression of serum PCT has the close correlation with the infection in patients with heart
failure, which has some diagnostic value in clinical application.

      【Key words】 Serum Procalcitonin; Heart failure; Infection; Diagnostic value
·论 著·
6350.2016.13.017