Wang Xinshui, Sun Yanbei, Shao Xiaonan
Department of Endocrinology, The Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu 213003, P.R. China.
Department of Nephrology, The Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu 213003, P.R. China.
Exp Ther Med. 2019 Jul;18(1):722-728. doi: 10.3892/etm.2019.7611. Epub 2019 May 24.
The aim of the present study was to investigate the predictive value of procalcitonin (PCT) for infection in patients with type 2 diabetes mellitus (T2DM). A retrospective analysis of 178 patients with T2DM who were divided into non-infection, local infection and sepsis groups was conducted; in conjunction with 33 healthy control patients. Clinicopathological characteristics and inflammatory indicators were compared between the four groups. Patients in the non-infection group exhibited significantly higher PCT levels compared with healthy controls (P=0.002). In addition, PCT, C-reactive protein (CRP), white blood cell count and neutrophil percent were significantly different amongst patients with T2MD across different infection groups (all P<0.001) with the following rank order: Sepsis group > local infection group > non-infection group (all P<0.05). In addition, the following observations were made: i) PCT and CRP demonstrated larger areas under the curve (AUC) for predicting local infection (0.804 and 0.741, respectively); ii) PCT displayed lower sensitivity of only 21.8% at its classical cutoff value (0.500 ng/ml) whereas CRP exhibited higher sensitivity and specificity at 64.1 and 76.1%, respectively, at its classical cutoff value (10.0 mg/l); and iii) PCT exhibited the largest AUC (0.914) for predicting sepsis with high sensitivity and specificity (86.4 and 84.5%, respectively) at its cutoff value (0.990 ng/ml). Patients with T2DM without infection demonstrated higher baseline PCT levels. The present study clarified the value of PCT in predicting infection of T2DM patients. The application of PCT to predict local infection in patients with T2DM was identified to be inferior to CRP, but its ability to predict sepsis was concluded to be the best when compared with CRP, white blood cell count and neutrophil percent.
本研究的目的是探讨降钙素原（PCT）对2型糖尿病（T2DM）患者感染的预测价值。对178例T2DM患者进行回顾性分析，将其分为非感染组、局部感染组和脓毒症组；并纳入33例健康对照患者。比较四组患者的临床病理特征和炎症指标。非感染组患者的PCT水平显著高于健康对照组（P=0.002）。此外，不同感染组的T2MD患者之间，PCT、C反应蛋白（CRP）、白细胞计数和中性粒细胞百分比存在显著差异（均P<0.001），排序如下：脓毒症组>局部感染组>非感染组（均P<0.05）。此外，还观察到以下情况：i）PCT和CRP在预测局部感染方面显示出较大的曲线下面积（AUC）（分别为0.804和0.741）；ii）PCT在其经典临界值（0.500 ng/ml）时敏感性仅为21.8%，而CRP在其经典临界值（10.0 mg/l）时敏感性和特异性较高，分别为64.1%和76.1%；iii）PCT在预测脓毒症方面显示出最大的AUC（0.914），在其临界值（0.990 ng/ml）时具有较高的敏感性和特异性（分别为86.4%和84.5%）。未感染的T2DM患者基线PCT水平较高。本研究阐明了PCT在预测T2DM患者感染方面的价值。研究发现，PCT在预测T2DM患者局部感染方面不如CRP，但与CRP、白细胞计数和中性粒细胞百分比相比，其预测脓毒症的能力最佳。
