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| 題 名 | 評估Procalciton、C-reactive Protein和White Blood Cell感染性指標在泌尿道感染的診斷應用度=Evaluation Procalciton, C-Reactive Protein and White Blood Cell Infection Markers in Urine Tract Infection Diagnosis Application |
|---|---|
| 作 者 | 鄭博文; 吳崇榮; 張旭男; 王淑貞; 莊邵宇; 施盛棟; 吳佩芬; 姜泰安; | 書刊名 | Journal of Biomedical & Laboratory Sciences |
| 卷 期 | 24:3 2012.09[民101.09] |
| 頁 次 | 頁92-100 |
| 分類號 | 415.8 |
| 關鍵詞 | 泌尿道感染; 前抑鈣素原; 接收操作特性圖; Urinary tract infection; Procalciton; Receiver operating characteristic curve; ROC curve; |
| 語 文 | 中文(Chinese) |
| DOI | 10.30046/JBLS.201209.0004 |
| 中文摘要 | 泌尿道感染是社區和院內最常見的細菌感染性疾病。如未即時處理則會造成腎臟感染發炎,而且 曾患尿道感染者,有容易有復發的傾向,導致腎臟衰竭而死亡。本研究探討前抑鈣素原 (Procalciton;PCT)在泌尿道系統感染性疾病早期診斷和鑑別診斷中的價值。以及比較PCT與現有的 CRP,WBC 等檢測方法在診斷上的效用,判斷疾病嚴重程度及治療指標。有助於減少抗生素不適 當使用,降低醫療支出。所有病例根據臨床病歷、出院診斷分為兩組:細菌感染組60例;非細菌性 感染組180例。分別檢測PCT、CRP、WBC。統計方法是利用接收操作特性圖(receiver operating characteristic(ROC) curve)來呈現診斷細菌感染的結果;分別檢定血清對泌尿道系統感染診斷的 Sensitivity、Specificity、Positive Predictive Value、Negative Predictive Value。PCT cut-off 0.49 ng/ml 結果分別為83.3%、100%、100%、94.7%;CRP cut-off 19.3 mg/L 結果分別為78.3%、63.9%、 42%、89.8%;WBC cut-off 9700 /uL結果分別為73.3%、53.9%、34.6%、85.8%;PCT的曲線下 面積最大為0.926, CRP 的曲線下面積為0.744,WBC 數的曲線下面積最小為0.648。綜合上述結 果顯示,泌尿道感染組與非細菌性感染組兩組患者血清PCT相比,差異有統計學意義(P<0.0001)。 PCT可以作泌尿道感染性疾病鑑別診斷可靠指標,有助於臨床醫生早期診斷和確定合理的治療方 案,值得臨床推廣應用。 |
| 英文摘要 | Objective: Urinary tract infections (UTI) are the most common bacterial infections in communities and hospitals, including kidney, ureter, bladder, urethra and prostate as well as other parts of the male by bacterial, fungal or viral invasions. But the main source of infection is bacteria. Urinary tract infections can be divided into three categories as symptomatic urinary tract infection, asymptomatic bacteria of urinary tract infections and other infections of the urinary tract. If no immediate action is taken, even a urinary tract infection with mild symptoms might result in inflammation of the kidney and urinary tract infection. This might lead to kidney failure and death. That may cause time delay in diagnosis and is possible to evolve into sepsis, or even result in inappropriate use of antibiotics. Therefore, the purpose of this study is to explore Procalciton (PCT) in early diagnosis of urinary tract infections and to compare PCT with the existing CRP, WBC and other detection methods in terms of disease severity and treatments in order to reduce inappropriate use of antibiotics and medical expenses. For this purpose, 60 patients (38 female, 22 male) were evaluated. 180 non-UTI patients (64 female, 116 male) made up the control group. Cut-off ranges of biomarkers must be chosen according to the specific clinical context and they should be used as a complementary tool, to reinforce the clinical diagnostic workup. Their diagnostic utilities were compared using Receiver operating characteristic (ROC) curves.ROC analysis showed that optimal discrimination in UTI could be performed at a cut-off point of 0.49 ng/ml for PCT (sensitivity 83.3 %; specificity 100% ; Positive Predictive Value 100%; Negative Predictive Value 94.7 %), 19.3 mg/L for CRP (sensitivity 78.3 %; specificity 63.9%; Positive Predictive Value 42%; Negative Predictive Value 89.8%) and 9700 for WBC (sensitivity 73.3 %; specificity 53.9 %; Positive Predictive Value 34.6 %; Negative Predictive Value 85.8 %). The areas under the ROC curves (95% confidence interval) for PCT, CRP and WBC were 0.926 (0.885-0.956), 0.744 (0.684-0.798) and 0.648 (0.584-0.708), respectively, and showed a significant difference. This study showed that procalcitonin could be a good indicator of UTI. |
本系統中英文摘要資訊取自各篇刊載內容。