Mori Ken-Ichi, Noguchi Mitsuru, Sumino Yasuhiro, Sato Fuminori, Mimata Hiromitsu
Department of Urology, Faculty of Medicine, Oita University, Idaigaoka 1-1, Hasama-cho, Yufu City 879-5593, Oita, Japan.
ISRN Urol. 2012;2012:431859. doi: 10.5402/2012/431859. Epub 2012 May 20.
Objectives. To investigate whether procalcitonin (PCT) could be useful for detecting bacterial infections in patients on hemodialysis (HD) and with increased calcitonin (CT). Methods. This prospective study included 42 males and 34 females on HD. The infection group consisted of 15 patients with proven bacterial infections; the other 61 patients were designated as the noninfection group. Serum C-reactive protein (CRP), interleukin (IL)-6, white blood cell (WBC) count, immature and total neutrophil (I/T) ratio, and CT were measured at the beginning of HD, and serum PCT levels at the beginning of HD and after HD. Results. The mean CT level in the both groups was apparently higher than that of nonchronic kidney disease. Significantly higher values between the infection and noninfection groups were seen for CRP, IL-6, WBC, I/T ratio, PCT, and CT. The PCT value of the area under the receiver operating characteristic curve was 0.921, which was significantly higher than the values for CRP (0.853; P < 0.01), IL-6 (0.739; P < 0.01), WBC (0.692; P < 0.01), and I/T ratio (0.584; P < 0.01). Conclusions. PCT was useful marker of bacterial infection in patients on HD and with increased CT. PCT levels should be determined before HD.
目的。探讨降钙素原（PCT）是否有助于检测血液透析（HD）患者及降钙素（CT）升高患者的细菌感染。方法。这项前瞻性研究纳入了42名男性和34名女性HD患者。感染组由15名经证实有细菌感染的患者组成；其他61名患者被指定为非感染组。在HD开始时测量血清C反应蛋白（CRP）、白细胞介素（IL）-6、白细胞（WBC）计数、未成熟和总中性粒细胞（I/T）比值以及CT，并在HD开始时和HD后测量血清PCT水平。结果。两组的平均CT水平明显高于非慢性肾病患者。感染组和非感染组之间的CRP、IL-6、WBC、I/T比值、PCT和CT值显著更高。受试者工作特征曲线下面积的PCT值为0.921，显著高于CRP（0.853；P<0.01）、IL-6（0.739；P<0.01）、WBC（0.692；P<0.01）和I/T比值（0.584；P<0.01）的值。结论。PCT是HD患者及CT升高患者细菌感染的有用标志物。应在HD前测定PCT水平。
