摘要
目的对降钙素原(PCT)、C-反应蛋白(CRP)、白细胞(WBC)计数、中性粒细胞(NEU)绝对数在早期血流感染(BSI)诊断中的效果进行对比,比较不同感染性指标的临床应用价值。方法选取2015年1-12月在医院接受血培养及进行PCT、CRP和血常规检查的BSI疑似患者216例,所选患者均接受一次检验,根据血培养结果分为血培养阴性组184例和血培养阳性组32例,对两组患者PCT、CRP、WBC、NEU和NEU比率等指标进行比较分析,并绘制受试者工作特征(ROC)曲线评价各指标的诊断价值。结果血培养阳性患者为32例,所占比例为14.81%,其中革兰阴性菌18例,革兰阳性菌8例,真菌6例;不同科室之间进行血培养阳性检出率差异具有统计学意义(P<0.05),其中ICU血培养阳性检出率最高为24.44%;血培养阳性组PCT、CRP、WBC、NEU分别为2.57(19.00)ng/ml、115.02(133.49)mg/L、10.92(9.51)×109/L、9.29(9.93)×109/L高于血培养阴性组0.05(0.03)ng/ml、57.31(50.00)mg/L、8.11(6.32)×109/L、6.03(5.31)×109/L(P<0.05);血清PCT敏感性和特异性最高,分别为85.34%和93.51%,WBC敏感性最低为42.68%,CRP特异性最低为52.20%;PCT、CRP、WBC、NEU的ROC曲线下面积(AUC)分别为0.88、0.73、0.70、0.67,差异有统计学意义(P<0.05)。结论 PCT、CRP、WBC、NEU等感染性指标均能有效诊断检测BSI疾病,其中PCT敏感性、特异性最高,具有良好的辅助诊断价值。CRP缺乏特异性但敏感性较高,能有效检测病毒细菌类型,PCT和CRP能辅助诊断早期BSI疾病。
OBJECTIVE To compare the counts of calcitonin （PCT）, C-reactive protein （CRP）, white blood cell （WBC）, absolute number of neutrophils （NEU） in the diagnosis of early bloodstream infections （BSI）, and com- pare the clinical application value of different infectious indexes.METHODS A total of 216 patients with BSI sus- pected and receiving blood culture and PCT, CRP and blood routine from Jan. to Dec. 2015 were enrolled in this study. 216 patients were enrolled in the hospital. All patients were tested and divided into blood culture negative group （184 cases） and blood culture positive group （32 cases） according to the results of blood culture. The scores of PCT, CRP, WBC, NEU and NEU were analyzed and compared of the two groups. The diagnostic value of each index was evaluated by the ROC curve of the subjects. RESULTS The blood culture positive patients were 32 ca- ses, and the proportion was 14.81%, among which gram-negative bacteria were 18 cases, gram-positive bacteria were 8 cases and fungi were 6 cases. The difference of blood culture positive rate between different departments was significant （P〈0.05）. The positive rate of ICU blood culture was the highest, which was 24.44%. The posi- tive rate of PCT, CRP, WBC and NEU in blood culture positive group was 2.57 （19.00） ng/ml, 115.02（133.49） mg/L, 10.92（9.51）× 109/L, and 9.29（9.93）×109/L, which were higher than 0.05（0.03）ng/ml, 57.31 （50.00）mg/L, 8.11（6.32）× 109/L, and 6.03（5.31）×109/L in blood culture negative group （P〈0.05）. The sensitivity and specificity of serum PCT were the highest, which were 85.34 % and 93.51%, respectively, and the sensitivity of WBC and the specificity of CRP were the lowest, which were 42.68% and 52.20%, respectively. The AUC of PCT, CRP, WBC and NEU were 0.88, 0.70, 0.70 and 0.67, respectively, and the differences were significant （P〈0.05）. CONCLUSION PCT, CRP, WBC, NEU and other infectious markers can effectively diagnose BSIdisease, in which the sensitivity and specificity of PCT are the highest, with good diagnostic value. CRP is lack of specificity but more sensitive, which can effectively detect the types of virus and bacteria. PCT and CRP can assist in the diagnosis of early BSI disease.
作者
彭胡
王春燕
邱厚兵
杨清明
PENG Hu;WANG Chun-yan;QIU Hou-bing;YANG Qing-ming(Luzhou Traditional Chinese Medicine Hospital, Luzhou, Sichuan 646000, Chin)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2018年第3期321-324,共4页
Chinese Journal of Nosocomiology
关键词
降钙素原
血流感染
C-反应蛋白
敏感性
特异性
Procalcitonin
Bloodstream infection
C-reactive protein
Sensitivity
Specificity
