摘要
目的探讨降钙素原(PCT)检测对重症加强护理病房(ICU)患者医院感染预测价值。方法方便选取2017年1月—2018年2月入住该院ICU的患者312例为研究对象,统计312例患者医院感染发生率,对比不同PCT水平、是否预防性应用抗菌药物患者之间医院感染发生率,进行与ICU医院感染相关的危险因素单因素分析,然后对于ICU医院感染相关的危险因素进行Logistic多因素分析。结果312例患者中发生医院感染74例,医院感染发生率23.72%,经单因素分析显示,年龄>60岁、PCT水平>0.5μg/L、血管内置管、泌尿道置管、气道插管、住院时间>14 d、未预防应用抗菌药物的ICU患者的医院感染发生率显著升高(χ^2=6.094、11.098、14.018、12.984、8.327、9.198、6.329,P<0.05);PCT≥0.5μg/L时预测ICU医院感染灵敏度为71.62%(53/74),特异度为96.22%(229/238),阴性预测值91.60%(238/250),阳性预测值85.48%(53/62);PCT临界值为2.0μg/L时预测医院感染灵敏度91.53%(54/59),特异度99.21%(251/253),阴性预测值98.05%(251/256),阳性预测值96.43%(54/56)。结论导致ICU患者发生医院感染的危险因素较多,检测PCT值有助于预测发生医院感染的危险性,并提前进行相关干预,以降低医院感染发生率。
Objective To investigate the predictive value of procalcitonin(PCT)detection in nosocomial infection in patients in intensive care unit(ICU).Methods A total of 312 patients who were admitted to the hospital from January 2017 to February 2018 were convenient selected as the research object.The incidence of nosocomial infection among 312 patients was compared.A single factor analysis of risk factors related to ICU nosocomial infection was performed,and then a logistic multivariate analysis of risk factors related to ICU nosocomial infection was performed.Results Of the 312 patients,74 had nosocomial infections,and the incidence of nosocomial infections was 23.72%.Univariate analysis showed that nosocomial infections occurred in ICU patients with age>60 years old,PCT level>0.5μg/L,intravascular catheter,urinary catheterization,airway intubation,and hospital stay>14 d,without antimicrobial application,the rate increased significantly.(χ^2=6.094,11.098,14.018,12.984,8.327,9.198,6.329,P<0.05).When PCT≥0.5μg/L,the ICU hospital infection sensitivity was predicted to be 71.62%(53/74),the specificity was 96.22%(229/238),the negative predictive value was 91.60%(238/250),and the positive predictive value was 85.48%(53/62).When the PCT cut-off value was 2.0μg/L,the predicted hospital infection sensitivity was 91.53%(54/59),specificity was 99.21%(251/253),negative predictive value was 98.05%(251/256),positive predictive value was 96.43%(54/56).Conclusion There are many risk factors leading to nosocomial infections in ICU patients,and the detection of PCT value can help to predict the risk of nosocomial infections and carry out related interventions in advance to reduce the incidence of nosocomial infections.
作者
胡丽娟
HU Li-juan(Department of Infection,Huanghua City People's Hospital,Huanghua,Hebei Province,061100 China)
出处
《中外医疗》
2020年第21期20-23,共4页
China & Foreign Medical Treatment
