摘要
目的 探究血清降钙素原(PCT)、C反应蛋白(CRP)及白细胞介素-6(IL-6)联合检测在血流感染诊断中的应用价值.方法 选择安阳市灯塔医院2022年2月—2023年2月收治的80 例疑似血流感染患者作为研究对象,以血液培养结果为金标准,将患者分为血流感染组、非血流感染组.所有试验者均检测血清PCT、CRP、IL-6水平,对比检验结果,计算诊断效能.结果 80 例患者经血液培养,阳性33 例(41.25%),致病菌33 株,其中革兰阳性球菌15 株(45.45%),革兰阴性杆菌18 株(54.55%).血流感染组患者的血清PCT、CRP、IL-6水平均高于非血流感染组,差异有统计学意义(P＜0.05).革兰阴性杆菌感染者的血清PCT水平明显高于革兰阳性球菌感染者,差异有统计学意义(P＜0.05).脓毒症组患者的血清PCT、CRP、IL-6水平均高于非脓毒症组患者,差异有统计学意义(P＜0.05).PCT+CRP+IL-6的特异度91.49%,灵敏度100%,准确度95.00%,阳性预测值89.19%,阴性预测值100%.PCT+CRP+IL-6的上述指标均高于单独PCT诊断、CRP诊断、IL-6诊断.结论 血清PCT、CRP、IL-6均可作为血流感染患者的辅助诊断指标,联合诊断能提高诊断效能.另外,PCT可用于鉴别诊断革兰阳性球菌、革兰阴性杆菌感染,还可诊断病情严重程度.
Abstract
Objective To investigate the application value of serum procalcitonin(PCT),C-reactive protein(CRP)and interleukin-6(IL-6)in the diagnosis of bloodstream infection.Methods 80 cases of suspected bloodstream infections admitted to Anyang Dengta Hospital from February 2022 to February 2023 were selected as the study subjects,and the patients were divided into the bloodstream infection group and the non-bloodstream infection group using the blood culture results as the gold standard.All test subjects were tested for serum PCT,CRP,IL-6,and the test results were compared to calculate the diagnostic efficacy.Results 80 patients were cultured by blood culture,33 cases(41.25%)were positive,and 33 strains of pathogenic bacteria were found,including 15 strains of Gram-positive cocci(45.45%)and 18 strains of Gram-negative bacilli(54.55%).Serum PCT level,CRP level,and IL-6 level of patients in the bloodstream infection group were higher than those in the non-bloodstream infection group,and the difference was statistically significant(P＜0.05).Serum PCT levels of Gram-negative bacillus-infected patients were significantly higher than those of Gram-positive cocci-infected patients,and the difference was statistically significant(P＜0.05).Serum PCT level,CRP level and IL-6 level of patients in the sepsis group were higher than those in the non-sepsis group,and the difference was statistically significant(P＜0.05).The specificity of PCT+CRP+IL-6 was 91.49%,the sensitivity was 100%,the accuracy was 95.00%,the positive predictive value was 89.19%,and the negative predictive value was 100%.The above indexes of PCT+CRP+IL-6 were higher than PCT diagnosis,CRP diagnosis and IL-6 diagnosis alone.Conclusion Serum PCT,CRP,and IL-6 can be used as auxiliary diagnostic indexes for patients with bloodstream infections,and combined diagnosis can improve diagnostic efficacy.In addition,PCT can be used for differential diagnosis of Gram-positive cocci and Gram-negative bacilli infections,and also for diagnosis of disease severity.
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