2018 年第 9 期 第 13 卷

血清降钙素原检测在心力衰竭合并感染诊断中的应用价值

Diagnostic value of serum procalcitonin in heart failure complicated with infection

作者：苏艳张玥刘义庆刘玲玲刘芸王勇张炳昌

英文作者：

单位：250021济南，山东大学附属省立医院临床医学检验部

英文单位：

关键词：心力衰竭；降钙素原；诊断界值

英文关键词：

• 摘要：

• 【摘要】目的    探讨血清降钙素原检测在心力衰竭合并感染诊断中的临床应用价值。方法    选取2014年6月至2015年5月山东大学附属省立医院住院患者187例，根据病情分为单纯感染组（59例）、单纯心力衰竭组（63例）和心力衰竭合并感染组（65例），另选取同期在我院体检中心体检的健康人100例作为正常对照组。根据纽约心脏病协会（NYHA）心功能分级标准，心力衰竭合并感染组65例患者中Ⅱ级21例、Ⅲ级23例、Ⅳ级21例。采用罗氏公司Cobas E601电化学发光免疫分析仪对受试人群血清降钙素原水平进行检测，行组间比较分析。结果    单纯感染组、单纯心力衰竭组、心力衰竭合并感染组降钙素原水平均明显高于正常对照组［（9.32±4.98）、（3.21±2.65）、（19.33±9.76）μg/L比（0.05±0.03）μg/L］，心力衰竭合并感染组降钙素原水平明显高于单纯感染组（均P＜0.01）。以0.05 μg/L作为诊断界值，降钙素原的诊断敏感度和阴性预测值随着NYHA心功能级别增长而呈逐渐上升趋势，而阳性预测值呈逐渐下降趋势。结论    心力衰竭可引起机体降钙素原水平升高。以降钙素原0.05 μg/L作为诊断界值时，其对单纯感染患者及不同心功能级别心力衰竭合并感染患者的诊断效能明显不同。

• 【Abstract】Objective    To investigate the diagnostic value of serum procalcitonin in heart failure complicated with infection. Methods    From June 2014 to May 2015, 187 patients were enrolled in Shandong Provincial Hospital Affiliated to Shandong University, including 59 simple infection, 63 heart failure and 65 infection with heart failure［New York Heart Association（NYHA） grade Ⅱ 21 cases, grade Ⅲ 23 cases, grade Ⅳ 21 cases］; 100 healthy people were enrolled as control group. Serum procalcitonin was tested using the Roche Cobas E601 chemiluminescence immunoassay analyzer. Results    The level of serum procalcitonin in simple infection group, heart failure group and heart failure with infection group was significantly higher than that in control group［（9.32±4.98）,（3.21±2.65）,（19.33±9.76）μg/L vs （0.05±0.03）μg/L］; the level of procalcitonin in heart failure with infection group was significantly higher than that in simple infection group（all P＜0.01）. With procalcitonin＝0.05 μg/L as the diagnostic threshold, the sensitivity and negative predictive value increased with NYHA heart failure grade, while the positive predictive value decreased gradually. Conclusions    Heart failure can lead to the increase of serum procalcitonin level. Procalcitonin＝0.05 μg/L shows different diagnostic efficiency among patients with simple infection and different grades of heart failure complicated with infection.