Application of point-of-care testing for procalcitonin in emergency clinical work

doi:10.3969/j.issn.1009-976X.2020.06.014

Abstract

Abstract: Objective The feasibility of point-of-care testing（POCT） for procalcitonin （PCT）in emergency clinical work was assessed. Methods PCT determination of whole blood samples from patients with suspected infection was implemented by POCT. The results from POCT were compared with that from a central laboratory. Results The clinical Turn-around Time （TAT） of PCT determination were significantly shortened by POCT. Consistency analysis of the results obtained by the two methods was carried out by kappa test. With 0.5 ng/mL and 2 ng/mL: as the critical points, the kappa coefficients are 0.786 and 0.923, and the results obtained by the two detection methods are highly consistent. Conclusion Determination of PCT by POCT is fast and reliable and it is suitable for emergency clinical work.

Key words: procalcitonin, point-of-care testing, turn-around time

摘要： 目的评估即时检测（POCT）全血降钙素原（PCT）应用于急诊临床的可行性。方法采用POCT法对疑诊感染患者的全血标本进行PCT测定,将结果与中心实验室检测结果进行对比。结果与中心实验室相比,POCT法显著缩短了临床周转时间（TAT）。通过kappa检验对两种方法获得的结果进行一致性分析,结果表明,以0.5 ng/mL和2ng/mL为临界点,kappa系数分别为0.786和0.923,两种检测方法所得结果一致性较好。结论 POCT法检测PCT快速可靠,适用于急诊临床工作。

关键词: 即时检测, 周转时间, 降钙素原

CLC Number:

R446

FENG Bi-juan, SHI Yi-ni, ZHONG Yu-lan, WU Hao, YU Tao, CHEN Fei-xia. Application of point-of-care testing for procalcitonin in emergency clinical work[J]. Lingnan Modern Clinics in Surgery, 2020, 20(06): 753-756.

冯碧娟, 施旖旎, 钟裕兰, 吴浩, 余涛, 陈飞霞. 即时检测全血降钙素原在急诊感染患者的应用价值[J]. 岭南现代临床外科, 2020, 20(06): 753-756.

References

[1] Chaudhary S, Bhatta NK, Lamsal M, et al.Serum procalcitonin in bacterial & non-bacterial meningitis in children[J]. BMC Pediatr, 2018, 18(1): 342.
[2] Choi JJ, McCarthy MW. Novel applications for serum procalcitonin testing in clinical practice[J]. Expert Rev Mol Diagn, 2018, 18(1): 27-34.
[3] Fakheri RJ.Can procalcitonin guide decisions about antibiotic management?[J]. Cleve Clin J Med, 2019, 86(5):307-311.
[4] 降钙素原急诊临床应用专家共识组.降钙素原(PCT)急诊临床应用的专家共识[J].中华急诊医学杂志,2012,21(9):944-951.
[5] 中国医师协会急诊医师分会,中国研究型医院学会休克与脓毒症专业委员会.中国脓毒症/脓毒性休克急诊治疗指南(2018)[J]. 感染、炎症、修复,2019,3(20):3-20.
[6] Waterfield T, Maney JA, Hanna M, et al.Point-of-care testing for procalcitonin in identifying bacterial infections in young infants: a diagnostic accuracy study[J]. BMC Pediatr, 2018, 18(1): 387.
[7] Pfäfflin A, Schleicher E.Inflammation markers in point-of-care testing (POCT)[J]. Anal Bioanal Chem, 2009, 393(5): 1473-1480.
[8] 吴文娟. 感染性疾病现场快速检验技术的现状与未来[J].中华检验医学杂志,2018,41(9):641-643.
[9] 孙胜男,吕菁君,魏捷.脓毒症患者降钙素原浓度与病原学感染证据之间的相关性研究[J].中华急诊医学杂志,2013,22(10):1136-1141.
[10] Kade G,Literacki S, Rzeszotarska A,et al.Removal of procalcitonin and selected cytokines during continuous venovenous hemodialysis using high cutoff hemofilters in patients with sepsis and acute kidney injury[J]. Blood Purif, 2018, 46(2): 153-159.
[11] 王彬,岳化葵,熊玮,等. POCT 检测肌红蛋白对心肌梗死的诊断价值[J]. 检验医学与临床,2018,15(5):722-724.
[12] Kankaanpää M, Holma-Eriksson M, Kapanen S, et al.Comparison of the use of comprehensive point-of-care test panel to conventional laboratory process in emergency department[J]. BMC Emerg Med, 2018, 18(1): 43.
[13] 胥国强,康清秀,李文楷,等. 5种床旁检测法与Abbott化学发光法检测心肌标志物的对比研究[J]. 四川医学,2018,39(2):157-160.
[14] Aldabbagh S, Marx B, Eis-Hübinger AM, et al.Rapid point-of-care testing for SARS-CoV-2 in a community screening setting shows low sensitivity[J]. Public Health, 2020, 182: 170-172.
[15] 朱蕾,韩冰,杜光艳. POCT与STAR在凝血检验和肝素治疗监测中的应用分析[J]. 标记免疫分析与临床,2015,7(22):706-707.
[16] 鲁礡. 全自动POCT 免疫定量分析系统检测降钙素原与罗氏电化学发光可比性研究[J]. 系统医学,2017,11(2):39-41.
[17] Musaad SM,Khan SA,Herd G.Point-of-care testing: High time for a dedicated National Adverse Event Monitoring System[J]. Clin Biochem Rev,2015,36(1): 3.
[18] Huddy JR, Ni MZ,Markar SR, et al.Point-of-care testing in the diagnosis of gastrointestinal cancers: Current technology and future directions[J]. World J Gastroenterol,2015,21(14): 411.
[19] Kitchen DP, Jennings I, Kitchen S, et al.Bridging the gap between point-of-care testing and laboratory testing in hemostasis[J]. Semin Thromb Hemost, 2015, 41(3): 272-278.