???? (PCT) ?????

1
???? (PCT) ?????

• ????????????
• ???????????

?????? ????
2
????????????????
3
???????????? ????????
??,??????????????????????(NDM_1),??????????????,
????,???????????????????
4
?????????????????
?????,?????????????????,????????????????,??
??????????????? ?????,?????????????????????
??????,???,?????????????????????????????21??,????
???????10????,????????????????20,80??????????
????????,??????????????,????????????
?????
5
????(PCT)(Procalcitonin)
????(PCT)???????,??116????????????????????????????
?????????? ????????,PCT??????? 1993?,????(M
Assicot)?????PCT????????????,?????????????????,???
??????????????????
6
PCT??????,????????11???????????????????????mRNA?,?
??????????,????????????PCT?
????? ???
11????? ??????
??
?????
??????
????( PCT)
???(CT)
??????? ?,????????
PCT?????
7

????
????

• PCT????????????, 23h????, 68h????????,
  1248h????, 23d??????
• ???????, PCT????????TNF2a?IL2?IL6
  ??????????????????????????????

?????,???C?????????????????
PCT????????????( lt 0.1ng/ml) ,????????????????,???
??2024h?
8
?????,CT????, PCT?????? PCR????PCT???? ????????
???
9
?????,???????IL-1???????TNF,??PCT???????,?????/???
????,PCT????????????????????????
????????????,??PCT?????
10
???????,???PCT? 2-3h???? , 6-8h????
12h-48????, 2-3d ????? ?????lt0.05ng/ml1000ng/ml
????15-20h??,?????????

• PCT??????

11
??? ??? ??? ??

• ??,??gt38?

?????,WBCgt10 109/L
????PCT??
PCTgt2ng/ml
PCTgt0.25-0.5ng/ml
???????????
????,????????????
???????,?????????
?????
?????????
????????????
12
PCT??????
PCT?? ??? ??? ??????lt0.25ng/ml
0.25-0.5 83 85 ???????????????
0.5-1 85 92 ??????
1-2 92 97 ??????,????????,????????????????,???????,?????
2-10.0 97 98 ?????????,???????,????,????,??????????????????
gt10 99 99 ????????????,?????????????????????(??????????????),???????,?????
13
PCT?????

• ????????????
• ??????????????????
• ???????????
• ???????
• PCT????????

14
PCT?????
??????????????????(WBC),??(ESR),C-????,??
??????,PCT????????????????????????????
?????????,PCT????????24???????????????lt0.5ng/ml???
,??PCT???????????????????????,??????????????????,?
???????
15
??????????????? ???????????
??
??
??
??
PCT????????,??????????,???????
16
?????????????

• ??SCCM??????????????????????????????????????,????
  
• ???????????????????????????????????????????????,??
  ??,????,????????????????????
• ????????????????????????????????????????????????
  ???????????????

17
?????????????

• ???????PCT??,???????,????????,???
  ?,???????,????????(????????)?PCT???????????????
• ???????????,PCT??????????,???????????
  ,PCT????,???gt10ng/ml???14d?,?????????????????????
  ?,?????????
• ??????PCT?????,????????,??????????,PCT?????
  ????,PCT?????????????????

18
PCT????????????
????????????????,?????????????????????
??????????????? ???????PCT ????,
???????????????????, ???????????????,??????????,
?????????????PCT ?????2 ng/ ml ?????,
????????????,??????????,?????????PCT
??,??????????? ??CRP ??????????,
???????????????????, ???????????????, ??PCT ??,
??????, ?????????????????????PCT
??????????????????????
19
PCT?????????
PCT??????,??????,?????????????87.
5,????92. 1 ,????????????????? ?PCT
lt 0. 1ng/ml??????????,
lt 0. 25ng/ml????????
gt 0. 25ng/ml????
gt 0. 5ng/ml??????? ?????PCT???????????
???????,??????????,???????????????????????????????
??
20

PCT??????????
?????????????????PCT???(lt0.25ng/ml)???,???????????
???PCT?(lt0.1ng/ml)???,??????????
21
(No Transcript)
22
??????????
???????????50(83-44)
23
PCT????????
??? ????,PCT????????????
???,???????????????????????PCT???????????????,????
???????????????????
24
????PCT????????????????
????????????,???
PCT??????,??????(???????)
25
?????PCT????????????????
?????,??????
?????PCT??,????????(????,??)
26
PCT???????????ICU?????????????

• ??? ???? gt 1.0ng/ml, ?????? 1.0ng/ml?????
• ?????????? 1.0ng/ml?????,?????? lt1.0ng/ml
• ?472?? (343 PCT gt 1.0ng)

??? ???
PCT 2.7ng/ml 16.0ng/ml
CRP 154.0 mg/L 173.5 mg/L
WBC 14.0 109/L 16.0 109/L
?? PCT ?????? (gt1.0ng/ml) ?90????????????PCT
??????????ICU?????????????????,CRP ? WBC
??????????.
27
PCT????????

• ?????,????????PCT????,??????PCT??????
• ?????,PCT????(lt24h)???????????????????????????
• ???,????????PCT????????????(13d)?????????????(???
  ??84,???91)
• ?????????,????????PCT???????????????????????PCT???
  ?????????

28
? ?

• ???????,??????????,??????????(????)
  ,????????????????????????
• ??????????????CRP??,????????????,?????,?????????
• ?????????, PCT??????,?????????,??????????????PCT
  ( lt 0. 5ng/ml) ,PCT?????????,???????????????????,?
  ?????????????????????
• PCT?????????,????????????,?????????,??????????????
  ??!

29
??!