文章摘要
尿液降钙素原在糖尿病合并尿路感染中的表达及意义
The Expression and Significance of Urine Procalcitonin in Urinary Tract Infections with Diabetes Mellitus
投稿时间:2019-01-09  修订日期:2019-01-14
DOI:
中文关键词: 降钙素原  糖尿病  尿路感染  无症状细菌尿
英文关键词: Procalcitonin  Diabetes mellitus  Urinary tract infections  Asymptomatic bacteriuria
基金项目:广东省自然科学基金项目(2016A030313286)
作者单位E-mail
HEAN Povkanha 中山大学附属第五医院内分泌与代谢病科 1355796214@qq.com 
杨小颖 中山大学附属第五医院内分泌与代谢病科 广东 珠海 519000 中国  
胡芳 中山大学附属第五医院内分泌与代谢病科 广东 珠海 519000 中国  
韦晓虹 中山大学附属第五医院内分泌与代谢病科 广东 珠海 519000 中国  
孙辽 中山大学附属第五医院内分泌与代谢病科 广东 珠海 519000 中国 sunliao@mail.sysu.edu.cn 
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中文摘要:
      目的:探讨尿液降钙素原 (PCT) 水平对糖尿病合并尿路感染的诊断价值及治疗效果监测。方法:选取2017年8月至2018年12月中山大学附属第五医院内分泌与代谢病科住院的糖尿病患者78例,其中合并真性细菌尿者为观察组 (39例),未合并尿路感染者为对照组 (39例),记录两组患者临床资料以及相关实验室检查结果,同时留取尿液标本,观察组分别留取使用抗生素治疗前、后的尿液标本。采用酶联免疫吸附测定 (ELISA) 法检测尿液PCT浓度。分别比较观察组与对照组,以及观察组治疗前、后的尿液PCT水平。结果:观察组尿液PCT水平0.030 (0.025, 0.039) ng/ml明显高于对照组0.017 (0.011, 0.021) ng/ml,差异有统计学意义 (P<0.05);ROC曲线下面积为0.81 (95 %CI为0.71-0.89, P<0.0001),尿液PCT对糖尿病合并尿路感染诊断的敏感度为82.05 %,特异度为79.49 %,阳性预测值为80.00 %,阴性预测值81.58 %;观察组有症状尿路感染与无症状细菌尿 (ABU) 的尿液PCT水平比较,差异无统计学意义 (P>0.05);观察组使用抗生素治疗后的尿液PCT水平为0.031 (0.025, 0.040) ng/ml,与治疗前相比较,差异无统计学意义 (P>0.05)。结论:尿液PCT水平对糖尿病合并尿路感染有一定诊断价值,对于抗生素疗效的监测还需进一步深入研究。
英文摘要:
      Objective: To investigate the diagnostic value and therapeutic effect of level of urine procalcitonin (PCT) in urinary tract infections with diabetes mellitus. Methods: A total of 78 diabetic patients who hospitalized in the Department of Endocrinology and Metabolic Diseases of the Fifth Affiliated Hospital of Sun Yat-Sen University from August 2017 to December 2018 were enrolled in this study. Patients with positive of midstream urine culture were divided into observation group (39 cases), while another without urinary tract infections were divided into control group (39 cases). The clinical record, examination results and urine samples of both groups were collected. Urine samples of observation group were collected twice, which were before and after antibiotics treatment. Enzyme-linked immunosorbent assay (ELISA) was used for measuring concentration of PCT in urine. The urine PCT levels of the observation group and the control group, and the observation group before and after treatment were compared. Results: The level of urine PCT of observation group was significantly higher than that of control group (P<0.05), whose median of PCT was 0.030 (0.025, 0.039) ng/ml and 0.017 (0.011, 0.021) ng/ml, respectively. The area under the ROC curve was 0.81 (95% CI was 0.71-0.89, P<0.0001). The sensitivity, specificity, positive predictive value and negative predictive value for diagnosing urinary tract infections with diabetes mellitus were 82.05 %, 79.49 %, 80.00 %, 81.58 %, respectively. There was no significant difference in level of urine PCT between symptomatic urinary tract infections and asymptomatic bacteriuria (ABU) in the observation group (P>0.05). The level of urine PCT in observation group was 0.031(0.025, 0.040)ng/ml after treatment, however, there was no significant difference between before and after treatment (P>0.05). Conclusions: The level of urine PCT has accessory diagnostic value for urinary tract infections with diabetes mellitus, but further study is needed to see if this could guide the therapeutic effect.
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