神经外科重症监护病房患者血清降钙素原水平在颅内感染诊断中的应用价值

Determination ofNICU Procalcitonin Level and Clinical Application of Infection Diagnosis

摘要: 目的：本研究旨在探讨神经外科重症监护病房(NICU)患者血清降钙素原水平在颅内感染诊断中的临床应用价值。方法：回顾性分析2年内在中国人民解放军第422医院NICU中接受血清降钙素原测定的神经外科患者的降钙素原水平。血清降钙素原水平 ≥ 0.2 ng/mL认定为阳性结果通过临床和/或微生物学诊断感染。以血清降钙素原水平 ≥ 0.2 ng/mL评估临床或微生物感染诊断的敏感性、特异性、阳性预测值和阴性预测值。结果：本研究的163名患者中，51名患者降钙素原测定阳性，降钙素原水平 > 0.2 ng/mL与感染无显著相关性。降钙素原水平 > 0.2 ng/mL的假阴性率为37.4%，假阳性率为11.0%，敏感性为35.1％，特异性为64.7%，阳性预测值为73.9%，阴性预测值为45.5%。结论：血清降钙素原作为生物标志物在NICU患者中诊断颅内感染的效用有限，应谨慎和有选择地使用血清降钙素原测定诊断颅内感染。

Abstract: Objective: The purpose of this study was to investigate the clinical value of serum procalcitonin levels in the diagnosis of intracranial infections in the Neurosurgical Intensive Care Unit (NICU). Methods: Retrospective analysis of procalcitonin levels in neurosurgical patients who received procalcitonin in the NICU of the 105th Hospital of Chinese People’s Liberation Army within 2 years. Serum procalcitonin levels ≥ 0.2 ng / mL were considered positive and were diagnosed by clinical and/or microbiological diagnosis. To assess the sensitivity, specificity, positive predictive value, and negative predictive value of clinical or microbial infection diagnosis with serum procalcitonin level ≥ 0.2 ng/mL. Results: Of the 163 patients in the study, 51 patients had positive procalcitonin measurements, and procalcitonin levels > 0.2 ng/mL were not significantly associated with infection. Procalcitonin levels > 0.2 ng/mL. The false negative rate was 37.4%, the false positive rate was 11.0%, the sensitivity was 35.1%, the specificity was 64.7%, the positive predictive value was 73.9%, and the negative predictive value was 45.5%. Conclusion: Procalcitonin as a biomarker has limited utility in diagnosing intracranial infections in NICU patients. Care should be taken to use a procalcitonin assay to diagnose intracranial infections with caution and selectivity.