Simon Liliana, Gauvin France, Amre Devendra K, Saint-Louis Patrick, Lacroix Jacques
Department of Pediatrics, Yale University School of Medicine, New Haven, CT 06520-8064, USA.
Clin Infect Dis. 2004 Jul 15;39(2):206-17. doi: 10.1086/421997. Epub 2004 Jul 2.
A meta-analysis was performed to evaluate the accuracy of determination of procalcitonin (PCT) and C-reactive protein (CRP) levels for the diagnosis of bacterial infection. The analysis included published studies that evaluated these markers for the diagnosis of bacterial infections in hospitalized patients. PCT level was more sensitive (88% [95% confidence interval [CI], 80%-93%] vs. 75% [95% CI, 62%-84%]) and more specific (81% [95% CI, 67%-90%] vs. 67% [95% CI, 56%-77%]) than CRP level for differentiating bacterial from noninfective causes of inflammation. The Q value for PCT markers was higher (0.82 vs. 0.73). The sensitivity for differentiating bacterial from viral infections was also higher for PCT markers (92% [95% CI, 86%-95%] vs. 86% [95% CI, 65%-95%]); the specificities were comparable (73% [95% CI, 42%-91%] vs. 70% [95% CI, 19%-96%]). The Q value was higher for PCT markers (0.89 vs. 0.83). PCT markers also had a higher positive likelihood ratio and lower negative likelihood ratio than did CRP markers in both groups. On the basis of this analysis, the diagnostic accuracy of PCT markers was higher than that of CRP markers among patients hospitalized for suspected bacterial infections.
进行了一项荟萃分析,以评估降钙素原(PCT)和C反应蛋白(CRP)水平测定对细菌感染诊断的准确性。该分析纳入了已发表的研究,这些研究评估了这些标志物在住院患者细菌感染诊断中的作用。在区分细菌感染与非感染性炎症原因方面,PCT水平比CRP水平更敏感(88%[95%置信区间(CI),80%-93%]对75%[95%CI,62%-84%])且更具特异性(81%[95%CI,67%-90%]对67%[95%CI,56%-77%])。PCT标志物的Q值更高(0.82对0.73)。PCT标志物区分细菌感染与病毒感染的敏感性也更高(92%[95%CI,86%-95%]对86%[95%CI,65%-95%]);特异性相当(73%[95%CI,42%-91%]对70%[95%CI,19%-96%])。PCT标志物的Q值更高(0.89对0.83)。在两组中,PCT标志物的阳性似然比也高于CRP标志物,阴性似然比低于CRP标志物。基于该分析,在因疑似细菌感染住院的患者中,PCT标志物的诊断准确性高于CRP标志物。