Author/Editor		Gabršček, Lucija; Voga, Gorazd; Krivec, Bojan; Skale, Rafael; Parežnik, Roman; Podbregar, Matej
Title		Pomen prokalcitonina pri prepoznavanju bakterijske okužbe
Translated title		The role of procalcitonin in bacterial infection recognition
Type		članek
Source		Zdrav Vestn
Vol. and No.		Letnik 70, št. Suppl 1
Publication year		2001
Volume		str. I-11-5
Language		slo
Abstract		Background. Early recognition of bacterial infection and antibiotic treatment are very important in critically ill patients. Procalcitonin (PCT) is a marker of bacterial infections accompanied by systemic inflammatory response. Higher values were also noticed with parasitical and fungal infections, but PCT is normal in viral and systemic diseases. The aim of this study was to assess whether PCT is better marker for bacterial infections than C-reactive protein (CRP) and if they have a prognostic value. Methods. 34 patients were included into our retrospective study. All of them had clinical or laboratory signs of infection at the first PCT determination. We measured PCT, CRP, erythrocyte sedimentation rate (SR) and leukocyte count. On the base of microbiologic results we divided patients into three groups. Group A had patients with sterile cultures, group B included the ones with negative blood cultures, but from other cultures causative agents were identified. The patients in group C had positive blood cultures. Retrospectively we studied PCT and CRP values among groups and among survivors and non survivors. Results. An average median value of PCT in group A was 8.9 +- 13.3 ng/ml, in group B 5.3 +- 9.3 ng/ml and in group C 21.0 +- 25.0 ng/ml. In group B, the average median value of PCT was significantly higher than in group C (p=0.019), but that was not the case in group A (p=0.23). The average median values of CRP were 129.9+-67.4mg/l in group A, 104.3 +- 60.1 mg/l in group B and 117.4 +- 46.1 mg/l in group C. Between groups, diferences of CRP values were not statistically significant. The average initial value of PCT in group of non survivors (8.9 +- 49) was not significantly higher then in group of survivors (3.14 +- 55.4) (p=0.48). (Abstract truncated at 2000 characters).
Summary		Izhodišča. Prepoznavanje bakterijskih okužb je pri kritično bolnih zelo pomembno in neposredno opredeljuje antibiotično zdravljenje. Prokalcitonin (PCT) je označevalec bakterijskega vnetja, ki ga spremlja sistemski odgovor organizma. Povišane vrednosti so ugotovili tudi pri glivičnih in parazitarnih okužbah, pri virusnih in sistemskih obolenjih pa so vrednosti PCT normalne. Želeli smo ugotoviti, ali prokalcitonin bolj zanesljivo opredeli bakterijsko okužbo kot C-reaktivni protein (CRP). Zanimala nas je napovedana vrednost PCT in CRP glede izhoda bolezni. Metode. V klinično, retrospektivno in opazovalno raziskavo smo vključili 34 bolnikov, ki so imeli ob prvi določitvi PCT klinične ali laboratorijske znake vnetja. Glede na mikrobiološki izvid smo bolnike razvrstili v tri skupine in merili vrednosti CRP, PCT in hitrost sedimentacije eritrocitov (SR) ter določali število levkocitov. V skupini A so bili bolniki s sterilnimi kužninami, v skupini B pa bolniki, pri katerih smo iz odvzetih kužnin osamili povzročitelja, vendar so bile hemokulture sterilne. V skupino C smo uvrstili bolnike, pri katerih smo iz hemokulture osamili povzročitelja. Retrogradno smo primerjali vrednosti CRP in PCT med posameznimi skupinami ter med umrlimi in preživelimi. Rezultati. Povprečna mediana vrednost PCT pri bolnikih v skupini A je bila 8,9 +- 13,3 ng/ml, v skupini B 5,3 +- 9,3 ng/ml in v skupini C 21,0 +- 25,0 ng/ml. Statistično pomembna razlika je bila le med skupinama B in C (p=0,019). Povprečne mediane vrednosti CRP so bile v skupini A 129,9 +-67,4 mg/l, v skupini B 104,3 +- 60,1 mg/l ter v skupini C 117,4 +- 46,1 mg/l. Vrednosti CRP se med skupinami niso statistično pomembno razlikovale. (Izvleček prekinjen pri 2000 znakih).
Descriptors		BACTERIAL INFECTIONS CALCITONIN CRITICAL ILLNESS C-REACTIVE PROTEIN SURVIVAL ANALYSIS