急性骨髓炎和脓毒性关节炎患者血清降钙素原水平的评价

Narendra Kumar, V. Pandey, D. Sharma, M. Patralekh, H. Lal
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摘要

目的:研究血清降钙素原(PCT)水平在急性骨髓炎(OM)和脓毒性关节炎(SA)早期诊断中的作用。环境与设计:这是一项在三级医院进行的前瞻性研究。研究对象和方法:本研究在一家三级保健医院进行。39例在门诊或急诊就诊的SA或急性OM患者被纳入研究。选取39例患者作为对照组,其中1例患者未随访,故对照组为38例。采用免疫荧光法测定PCT水平,以0.5 ng/ml为阳性。收集资料后,计算PCT的敏感性、特异性、阳性预测值、阴性预测值。采用统计学分析:采用Mann-Whitney u检验和Kruskal-Wallis检验。结果:PCT的敏感性为94.87(95%可信区间[CI] 82.68 ~ 99.37),特异性为86.84 (95% CI 71.91 ~ 95.59),以0.5 ng/ml为截止值时,阳性预测值为88.10%,阴性预测值为94.29%。我们将0.5 ng/ml作为PCT的临界值;然而,根据本研究的受试者操作者特征,截止点为1.1 ng/ml。结论:本研究明确显示PCT与其他指标如白细胞总数、红细胞沉降率、c反应蛋白等一起有助于OM和SA的早期诊断。
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Evaluation of serum procalcitonin levels in patients of acute osteomyelitis and septic arthritis
Aims: The aim is to study the role of serum procalcitonin (PCT) levels in early diagnosis of acute osteomyelitis (OM) and septic arthritis (SA). Settings and Design: This is a prospective study in a tertiary hospital. Subjects and Methods: This study was done at a tertiary care hospital. Thirty-nine patients with SA or acute OM who attended the outpatient department or emergency were included in the study. 39 patients were taken as control group out of which one patient lost to follow-up, so 38 patients were left with control group. PCT level was evaluated by using immunoluminetric assay and a cutoff value of 0.5 ng/ml was taken as positive. After collection of data, sensitivity, specificity, positive predictive value, and negative predictive value are calculated for PCT. Statistical Analysis Used: Mann–Whitney U-test and Kruskal–Wallis test were used. Results: The sensitivity for PCT was 94.87 (95% confidence interval [CI] 82.68–99.37), specificity was 86.84 (95% CI 71.91–95.59), positive predictive value was 88.10%, and negative predictive value was 94.29%, when taking cutoff of 0.5 ng/ml. We have taken 0.5 ng/ml as a cutoff point for PCT; however, as per receiver operator characteristic of this study, the cutoff point was 1.1 ng/ml. Conclusions: This study clearly showed that PCT can be helpful in the early diagnosis of OM and SA, along with other indicators such as total leukocyte count, erythrocyte sedimentation rate, and C-reactive protein.
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