Canavaggio P, Boutolleau D, Goulet H, Riou B, Hausfater P
a Department of Emergency , Pitié-Salpêtrière University Hospital, Assistance Publique-Hôpitaux de Paris (APHP) , Paris , France.
b Virology Laboratory , Pitié-Salpêtrière University Hospital, Assistance Publique-Hôpitaux de Paris (APHP) , Paris , France.
Biomarkers. 2018 Feb;23(1):10-13. doi: 10.1080/1354750X.2016.1276626. Epub 2017 Jan 12.
We aimed to determine whether serum procalcitonin (PCT) values could help in identifying flu in patient admitted to the emergency department (ED) with influenza-like illness (ILI) during influenza A(H1N1)2009 pandemic.
An observational retrospective cohort study was performed in a referral ED for emerging infectious diseases. All patients tested for influenza A(H1N1)2009 by Reverse Transcriptase-Polymerase Chain Reaction (RT-PCR) and procalcitonin between June 2009 and January 2010 were analyzed. PCT was studied for its negative predictive value of bacterial infection. Patients PCT-/RT-PCR + were considered as true positive.
On the 80 patients included, 16 were positive for influenza A(H1N1)2009 RT-PCR, all but one of them had low PCT concentrations. Conversely, 19 (30%) of the 64 patients with negative RT-PCR had elevated PCT concentrations. For a PCT threshold <0.25 μg/L, sensitivity was 0.94, specificity 0.30, positive predictive value 0.25 and negative predictive value 0.95 for the diagnosis of flu.
In the context of an influenza pandemic, serum PCT measurement may be useful for clinical decisions in the ED as most of RT-PCR confirmed patients have low PCT values. Patients with PCT above 0.25 μg/L are unlikely to have a unique diagnosis of flu.
我们旨在确定血清降钙素原（PCT）值是否有助于识别在2009年甲型H1N1流感大流行期间因流感样疾病（ILI）入住急诊科（ED）的患者是否感染流感。
在一家转诊的新兴传染病急诊科进行了一项观察性回顾性队列研究。分析了2009年6月至2010年1月期间所有通过逆转录聚合酶链反应（RT-PCR）检测2009年甲型H1N1流感并检测降钙素原的患者。研究PCT对细菌感染的阴性预测价值。PCT阴性/RT-PCR阳性的患者被视为真阳性。
纳入的80例患者中，16例2009年甲型H1N1流感RT-PCR检测呈阳性，除1例患者外，其余患者的PCT浓度均较低。相反，64例RT-PCR检测阴性的患者中有19例（30%）PCT浓度升高。对于PCT阈值<0.25μg/L，诊断流感的敏感性为0.94，特异性为0.30，阳性预测值为0.25，阴性预测值为0.95。
在流感大流行的背景下，血清PCT检测可能有助于急诊科的临床决策，因为大多数RT-PCR确诊的患者PCT值较低。PCT高于0.25μg/L的患者不太可能仅诊断为流感。
