血清降钙素原和C反应蛋白在血流感染中的诊断价值
Diagnostic values of serum procalcitonin and C-reactive protein levels in bloodstream infection
罗玮 1李莉 1孔繁荣1
作者信息
- 1. 青岛市市立医院 检验科，山东 青岛 266011
- 折叠
摘要
目的：探讨血清降钙素原（PCT）和 C 反应蛋白（CRP）水平对血流感染患者的临床诊断价值。方法对我院2012年4月至2015年3月期间住院患者的血培养及血清 PCT 和 CRP 水平进行回顾性研究分析。采用 Mann-Whitney U 检验分别比较血培养结果与 PCT 及 CRP 水平的关系，并绘制 ROC 曲线比较 PCT 及 CRP 对血流感染的诊断价值。结果血培养阳性组和阴性组的 PCT 水平分别为3．26（0．83-12．00）μg／L，0．31（0．21-0．43）μg／L（P ＜0．000）。血培养阳性组和阴性组的 CRP 水平为77．52（24．92-129．58）mg／L，31．84（11．79-45．05）mg／L（P ＜0．004）。PCT 和 CRP 对血流感染的最佳临界值分别为0．72μg／L 和57．08 mg／L，ROC 曲线下面积分别为0．91和0．75。血培养革兰阴性细菌组与阳性细菌组 PCT 水平差异有统计学意义，而 CRP 水平差异无统计学意义。结论CRP 和PCT 均可作为血流感染的早期快速诊断指标，且 PCT 诊断血流感染的特异性及敏感性均高于 CRP。PCT 对革兰阴性细菌血流感染患者的诊断价值较阳性细菌血流感染诊断价值高。
Abstract
Objective To evaluate the diagnostic value of the serum levels of procalcitonin (PCT)and C-reactive protein (CRP)in patients with bloodstream infection.Methods Blood cultures,PCT and CRP levels of the inpatients admitted to Qingdao Municipal Hospital between April 2012 and March 2015 were analyzed retrospectively.The rela-tionships between blood culture results and PCT levels and CRP levels were investigated by Mann-Whitney U test.And the effectiveness of PCT and CRP as diagnostic markers for bloodstream infection (BSI)was determined by using re-ceiver operating characteristic (ROC)curve analysis.Results The median PCT concentrations were respectively 3.26 (0.83-12.00)and 0.31(0.21-0.43)μg/L(P <0.000)in the patients with positive blood culture and the patients with negative blood culture;and the median CRP concentrations were respectively 77.52(24.92-129.58)and 31.84(11.79-45.05)mg/L(P <0.004).In the ROC analysis,the cutoff level of 0.72 μg/L for PCT and 57.08 mg/L for CRP were optimal for diagnosing BSI.And the area under the curve was 0.91 for PCT and 0.75 for CRP.Conclusion Both of CRP and PCT are effective early diagnostic markers of BSI and PCT has higher specificity and sensitivity than CRP. And the diagnostic value of PCT for patients with gram-negative bacteria bloodstream infections is higher than the pa-tients with gram-positive bacteria bloodstream infections.
关键词
血流感染/降钙素原/C/反应蛋白/血培养Key words
Bloodstream infection/Procalcitonin/C-reactive protein/Blood culture引用本文复制引用
出版年
2016
NETL
NSTL
维普
万方数据