Department of Respiratory Medicine, Chugoku Rosai General Hospital, Hiroshima, Japan.
J Microbiol Immunol Infect. 2010 Jun;43(3):222-7. doi: 10.1016/S1684-1182(10)60035-7.
BACKGROUND/PURPOSE: The efficacy of the rapid semi-quantitative procalcitonin (PCT) test for the diagnosis of bacterial infection was evaluated in patients with systemic inflammatory response syndrome.
A retrospective observational study was performed from June to December 2008 at the Chugoku Rosai General Hospital, Japan. This study analyzed consecutive patients (both outpatients and inpatients) who developed systemic inflammatory response syndrome and whose PCT test was measured semi-quantitatively within 24 hours of onset, or at the first hospital visit. Based on the clinical diagnosis, the patients were divided into two groups. Group I comprised patients with a bacterial infection, and group II comprised patients with a non-bacterial infection, or non-infectious disease. Receiver operating characteristic curves were used to evaluate the diagnostic value of the semi-quantitative PCT test kit, C-reactive protein levels and white blood cells counts for the detection of bacterial infections, and the areas under the resulting curves were compared.
A total of 168 patients were included and divided into groups I (n=112) and II (n=56). Group I showed a significantly higher percentage of positive PCT tests (≥ 0.5 ng/mL) than group II (67.8%vs. 19.6%, p < 0.001). PCT showed a sensitivity of 67.8% [95% confidence interval (CI)=58.4-76.4] and a specificity of 80.4% (95% CI=67.6-89.8). The areas under the resulting curves for PCT (0.764) were significantly larger than those seen for C-reactive protein (0.650, p=0.02) and white blood cells (0.618, p=0.006).
The semi-quantitative PCT test is as useful for distinguishing bacterial infection from other inflammatory diseases in common clinical practice as the quantitative PCT.
背景/目的：评估快速半定量降钙素原（PCT）检测在全身炎症反应综合征患者中对细菌感染诊断的疗效。
这是一项 2008 年 6 月至 12 月在日本中国 ROSAI 综合医院进行的回顾性观察性研究。该研究分析了连续出现全身炎症反应综合征且在发病后 24 小时内或首次就诊时进行半定量 PCT 检测的患者（包括门诊和住院患者）。根据临床诊断，将患者分为两组。I 组为细菌感染患者，II 组为非细菌感染或非传染性疾病患者。采用受试者工作特征曲线评估半定量 PCT 检测试剂盒、C 反应蛋白水平和白细胞计数检测细菌感染的诊断价值，并比较由此产生的曲线下面积。
共纳入 168 例患者，分为 I 组（n=112）和 II 组（n=56）。I 组 PCT 检测阳性率（≥0.5ng/mL）明显高于 II 组（67.8% vs. 19.6%，p<0.001）。PCT 的灵敏度为 67.8%（95%CI=58.4-76.4），特异性为 80.4%（95%CI=67.6-89.8）。PCT 的曲线下面积（0.764）明显大于 C 反应蛋白（0.650，p=0.02）和白细胞（0.618，p=0.006）。
在常规临床实践中，半定量 PCT 检测与定量 PCT 一样，可用于鉴别细菌感染与其他炎症性疾病。
