量化功能与前素之间的关系:对14431种血液培养物的研究
Albert K Park1, Trisha S Nakasone2, Amit Kaushal1,2
1Department of Medicine, Stanford University School of Medicine, Stanford, California, USA.
Open forum infectious diseases
|November 13, 2025
概括
在患有功能障碍的患者中,对诊断细菌血流感染的普罗卡尔西托尼 (PCT) 水平不那么可靠. 功能障碍显著增加了积极PCT结果的可能性,无论感染状态如何.
科学领域:
- 临床微生物学 临床微生物学
- 腎臟病學 (nephrology) 是一種醫學專業.
- 传染性疾病 传染性疾病
背景情况:
- 甲素 (PCT) 是一种用于评估细菌血流感染的生物标志物.
- 在患有功能障碍的患者中PCT的可靠性尚未得到充分证实.
- 功能障碍可能会影响PCT水平,使感染诊断复杂化.
研究的目的:
- 为了研究估计的膜过率 (eGFR) 和积极的PCT值之间的关系.
- 为了评估功能如何影响PCT可靠性在怀疑细菌血流感染.
- 量化慢性病阶段对PCT诊断精度的影响.
主要方法:
- 对2832名患者进行了回顾性队列研究,其中14431人接受了血液培养.
- 在血液培养物采集后48小时内分析PCT值.
- 多变量逻辑回归用于评估eGFR类别与阳性PCT (≥0.5 ng/mL) 之间的关联,并根据年龄和种族进行调整.
主要成果:
- 在患有严重功能障碍的患者中,与正常功能患者相比 (分别为47.0%和27.6%) 的患者中,PCT阳性比例更高 (91.7%的阳性培养,84.0%的负性培养).
- 较低的eGFR类别与呈阳性PCT值的几率增加40-43%有关.
- 功能和阳性PCT之间的这种反向关系在各种PCT值中是一致的.
结论:
- 在患有和没有血流感染的患者中,功能和阳性PCT值之间存在反向关系.
- 在患有功能障碍的患者中,PCT对血液感染的诊断效用降低.
- 对PCT结果的临床解释需要考虑患者的功能状态.
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