Shokouhi Behrooz, Bookani Kaveh Rezaei, Ghasemi Hossein, Khalouei Mahmoud, Rezaei Naghmeh Javanshir, Samani Simin Mirakhor
Department of Pathology, Tabriz University of Medical Sciences, Tabriz, Iran.
Internal Medicine Department, Medstar Harbor Hospital, Baltimore, Maryland, USA.
Rev Assoc Med Bras (1992). 2017 Jun;63(6):521-526. doi: 10.1590/1806-9282.63.06.521.
: To examine the diagnostic and prognostic performances of serum procalcitonin (PCT) in adult and elderly patients with bloodstream infections (BSIs).
: A total of 176 patients with culture-proven BSIs and 200 healthy counterparts were studied prospectively. Participants were studied in two adult (age≤65 years, n=92) and elderly (age>65 years, n=84) groups. Admission serum PCT level was measured using a standard enzyme-linked immunosorbent assay (ELISA) technique.
: The mean serum PCT level (in ng/mL) was significantly higher in cases than in controls (0.18 vs. 0.07, p=0.01 in adults; 0.20 vs. 0.07, p=0.002 in elderly). At cut-off values of 0.09 ng/mL in adults and 0.08 ng/mL in the elderly, the corresponding sensitivity and specificity were 82.6 and 82.0% in adults, and 69.1 and 70.0% in elderly, respectively. At a cut-off value of 0.2 ng/mL, the sensitivity and specificity of serum PCT in predicting 28-day mortality were 81 and 81.7% in adults, and 75 and 80.4% in elderly, respectively.
: Although admission serum PCT is a sensitive and specific biomarker for the diagnosis of BSIs in patients younger than 65 years old, its short-term prognostic value is comparable between adults and the elderly.
探讨血清降钙素原(PCT)在成年和老年血流感染(BSI)患者中的诊断和预后价值。
前瞻性研究了176例经培养证实的BSI患者和200例健康对照者。参与者分为两个成年组(年龄≤65岁,n = 92)和老年组(年龄>65岁,n = 84)。采用标准酶联免疫吸附测定(ELISA)技术测定入院时血清PCT水平。
病例组血清PCT平均水平(ng/mL)显著高于对照组(成年组:0.18 vs. 0.07,p = 0.01;老年组:0.20 vs. 0.07,p = 0.002)。在成年组截断值为0.09 ng/mL、老年组截断值为0.08 ng/mL时,相应的敏感度和特异度在成年组分别为82.6%和82.0%,在老年组分别为69.1%和70.0%。在截断值为0.2 ng/mL时,血清PCT预测28天死亡率的敏感度和特异度在成年组分别为81%和81.7%,在老年组分别为75%和80.4%。
虽然入院时血清PCT是65岁以下患者诊断BSI的敏感且特异的生物标志物,但其短期预后价值在成年人和老年人中相当。