血清降钙素原水平测定对血液透析中心静脉留置导管相关性血流感染的诊断价值

刘小平张桂玉

(河北省唐山市工人医院血液透析室河北唐山063000)

[摘要]①目的探讨血清降钙素原(PCT)对血液透析中心静脉导管留置血流感染的早期诊断价值。②方法选择我院血液透析中心静脉导管留置相关性血流感染者60例为观察组，同期入选无感染者60例为对照组，检测两组患者的白细胞计数(WBC)、高敏C反应蛋白(hs-CRP)、PCT等指标。③结果观察组感染病原菌主要为革兰阳性菌，其中金黄色葡萄球菌24例(40.0%)，表皮葡萄球菌16例(26.7%)，耐甲氧西林葡萄球菌11例(18.3%)；其次为革兰阴性菌，其中大肠杆菌4例(6.7%)，洋葱假单胞菌2例(3.3%)，其他3例(5.0%)。观察组WBC、hs-CRP、PCT等指标显著高于对照组。差异有统计学意义(P<0.05)； ④结论PCT对血液透析中心静脉导管留置相关血流感染的早期诊断具有重要的临床价值。

[关键词]导管留置血液透析血清降钙素原血流感染

[中图分类号]R 54[文献标识码]A

【作者简介】刘小平(1973-)，本科，女，副主任护师。研究方向：血液净化。

PCT level determination of hemodialysis center of diagnostic value of intravenous indwelling catheter related bloodstream infectionsLIUXiaoping,ZHANGGuiyu(Workers,HospitalBloodDialysisRoominTangshanCity,Tangshan063000,China)

ABSTRACT[]ObjectiveTo explore serum calcitonin original (PCT) on blood dialysis centers the early diagnostic value of intravenous catheter indwelling bloodstream infections.MethodsSelected hemodialysis center venous catheter related bloodstream infections lien 60 cases for the team,at the same time was no infection 60 cases for the study of comparison,detection of two groups of white blood cell count (WBC),high-sensitivity c-reactive protein (hs CRP) and serum calcitonin original (PCT),and other indicators;Observe the infection pathogens;Observe the WBC,hs CRP and PCT of the ROC curve analysis.Observe the infection pathogens;Observe the WBC,hs CRP and PCT of the ROC curve analysis.ResultsTeam main for gram positive bacteria infection pathogens,including staphylococcus aureus,24 cases (40.0%) and the epidermis staphylococcus 16 cases(26.7%),methicillin-resistant staphylococcus aureus in 11 cases (18.3%),followed by gram-negative bacteria,including e.coli,4 cases (6.7%),pseudomonas onion in 2 cases (3.3%),other 3 cases (5.0%).Group of white blood cell count (WBC),high-sensitivity c-reactive protein (hs CRP) and serum calcitonin indices such as the original (PCT) is significantly higher than the control group,PCT of the critical point of 1.5 mu g/l,specific degree,sensitivity,AUC is significantly higher than the hs CRP,WBC,the difference was statistically significant (P<0.05).ConclusionPCT of hemodialysis center venous catheter related bloodstream infections lien early diagnosis has important clinical value.

[KEYWORDS]Gatheter indwelling.Hemodialysis.Calcitonin original.Blolldstream infection

中心静脉临时置管是血液透析患者常用的血管通路，是保证急诊和短时血液透析及永久性血管通路成熟以前透析顺利的关键[1]。静脉留置导管相关性血流感染(CRBSI)是血管通路使用过程中最为严重的并发症之一。血液透析血管通路是否畅通直接影响患者的透析质量和生存周期，是危重症患者晚期死亡的主要原因之一。 有研究指出，血清降钙素原(PCT)水平与血液透析中心静脉导管留置相关性血流感染密切相关，对确诊其是否感染具有重要的临床价值[2]。笔者对我院血液透析中心CRBSI患者进行PCT水平的测定，评估PCT对临时性CRBSI的早期诊断价值，报告如下。……