Giamarellou H, Giamarellos-Bourboulis E J, Repoussis P, Galani L, Anagnostopoulos N, Grecka P, Lubos D, Aoun M, Athanassiou K, Bouza E, Devigili E, Krçmery V, Menichetti F, Panaretou E, Papageorgiou E, Plachouras D
4th Department of Internal Medicine, Athens Medical School, Athens, Greece.
Clin Microbiol Infect. 2004 Jul;10(7):628-33. doi: 10.1111/j.1469-0691.2004.00883.x.
In order to assess the diagnostic value of procalcitonin, 158 patients with febrile neutropenia from centres across Europe were studied. Patients with fever were diagnosed on the basis of either: (1) clinical, radiological and microbiological criteria; or (2) the procalcitonin value. In the latter case, concentrations of 0.5-1.0 ng/mL were considered diagnostic of localised infection, concentrations of 1.0-5.0 ng/mL of bacteraemia, and concentrations of > 5.0 ng/mL of severe sepsis. Procalcitonin and C-reactive protein were estimated daily in serum by immunochemiluminescence and nephelometry, respectively. Overall, the sensitivity (specificity) of procalcitonin for bacteraemia was 44.2% (64.3%) at concentrations of 1.0-5.0 ng/mL, and 83.3% (100%) for severe sepsis at concentrations of > 5.0 ng/mL. It was concluded that procalcitonin is a marker strongly suggestive of severe sepsis at concentrations of > 5.0 ng/mL. Estimated concentrations of < 0.5 ng/mL indicate that infection is unlikely, but it was observed that bacteraemia associated with coagulase-negative staphylococci may fail to elevate serum procalcitonin levels.
为评估降钙素原的诊断价值，对来自欧洲各地中心的158例发热性中性粒细胞减少症患者进行了研究。发热患者根据以下标准之一进行诊断：（1）临床、影像学和微生物学标准；或（2）降钙素原值。在后一种情况下，浓度为0.5 - 1.0 ng/mL被认为是局部感染的诊断标准，1.0 - 5.0 ng/mL为菌血症，浓度> 5.0 ng/mL为严重脓毒症。分别通过免疫化学发光法和散射比浊法每日测定血清中的降钙素原和C反应蛋白。总体而言，降钙素原对菌血症的敏感性（特异性）在浓度为1.0 - 5.0 ng/mL时为44.2%（64.3%），对浓度> 5.0 ng/mL的严重脓毒症为83.3%（100%）。得出的结论是，降钙素原在浓度> 5.0 ng/mL时是严重脓毒症的一个强烈提示指标。估计浓度< 0.5 ng/mL表明感染可能性不大，但观察到与凝固酶阴性葡萄球菌相关的菌血症可能不会使血清降钙素原水平升高。
