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重庆市红十字会医院/江北区人民医院
纸质出版日期:2017,
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郑超, 乔陈财, 陈奕, 等. 菌血症患者细菌感染程度与血清PCT、hs-CRP水平变化研究[J]. 重庆医科大学学报, 2017,42(2):240-243.
Zheng Chao, Qiao Chencai, Chen Yi, et al. Bacteremia in patients with bacterial infection and changes in serum PCT and hs-CRP levels[J]. Journal of Chongqing Medical University, 2017,42(2):240-243.
郑超, 乔陈财, 陈奕, 等. 菌血症患者细菌感染程度与血清PCT、hs-CRP水平变化研究[J]. 重庆医科大学学报, 2017,42(2):240-243. DOI: 10.13406/j.cnki.cyxb.001170.
Zheng Chao, Qiao Chencai, Chen Yi, et al. Bacteremia in patients with bacterial infection and changes in serum PCT and hs-CRP levels[J]. Journal of Chongqing Medical University, 2017,42(2):240-243. DOI: 10.13406/j.cnki.cyxb.001170.
目的:探讨血清降钙素原(procalcitonin
PCT)、超敏C反应蛋白(high sensitivity C-reactive protein
hs-CRP)水平诊断细菌感染特异性
探讨其作为判断细菌感染严重程度及抗生素治疗敏感性指标的可行性。方法:选取2013年7月至2015年7月入院的患者为研究对象
其中实验室血培养结果为阴性无细菌感染对照组(A组)20例
实验室行血培养确诊为细菌感染者120例
将确诊病例分为局部细菌感染组(B组)40例
细菌感染性SIRS组(C组)40例;脓毒血症组(D组)40例。各细菌感染病例均使用抗生素
治疗前均检测血清PCT、hs-CRP水平
治疗24 h、4 d、7 d后
再次检测PCT、hs-CRP水平
进行方差分析和ROC曲线分析。结果:单因素方差分析显示
4组患者PCT和hs-CRP水平差异具有统计学意义(F=22.27
P=0.000;F=132.20
P=0.000);采用SNK法进行多重比较显示
对于PCT
B、C、D组细菌感染患者水平均高于A组(P=0.000)
而3个感染组之间差异无统计学意义(P>0.05);对于hs-CRP
A、B、C、D 4个组两两之间水平差异均具有统计学意义(P=0.000)。在使用抗菌药物治疗之前
脓毒血症患者的血清PCT水平显著升高
在细菌感染被成功控制后
患者的血清PCT水平迅速下降
达到正常水平
而CRP的下降水平较慢(P<0.05)。血清PCT检测对细菌感染性疾病的诊断特异性(87.02%)及敏感性(80.98%)均高于hs-CRP
差异有统计学意义(P<0.05)。结论:血清PCT、hs-CRP水平诊断细菌感染特异性
作为细菌感染严重程度及抗生素治疗敏感性指标的可行性高
对临床具有指导意义
值得临床推广。
Objective:To investigate the specificity of serum procalcitonin(PCT)
high-sensitivity C-reactive protein(hs-CRP)levels in the diagnosis of bacterial infection
and to explore the feasibility of taking them as index for judging the bacterial infection severity and antibiotic sensitivity. Methods :Hospital patients from July 2013 to July 2015 were selected as the research objects. Patients with negative results from laboratory blood culture and no bacterial infection were taken as control group(group A
20 cases). A total of 120 patients had lab blood culture and were confirmed to be bacterial infection
including local bacterial infection group(group B
40 cases)
bacterial infection SIRS group(group C
40 cases)and sepsis group(group D
40 cases). Antibiotics was used in each bacterial infections. Serum PCT
hs-CRP levels before the treatment and 24 hours
4 days
7 days after treatment were detected. Analysis of variance and ROC curve analysis were performed. Results:Single factor analysis of variance showed that there were statistically significant differences in PCT and hs-CRP levels among four groups(F=22.27
P=0.000;F=132.20
P=0.000). SNK method was used to do multiple comparison and the results showed that the PCT level was higher in group B
group C
group D than in group A(P=0.000)
and there was no statistically significant difference between three infection groups(P >0.05). There were statistically significant differences in hs-CRP level among A
B
C
D four groups(P=0.000). Before the use of antimicrobial drugs treatment
the serum PCT level of patients with sepsis was significantly increased;after the bacterial infection being successfully controlled
the patient’s serum PCT level was decreased rapidly
reaching normal levels
while CRP level was declined slowly(P<0.05).The specificity(87.02%)and sensitivity(80.98%)of serum PCT in the diagnosis of bacterial infectious diseases were higher than those of hs-CRP
with statistically significant differences(P<0.05). Conclusion:Serum PCT and hs-CRP levels have high specificity in the diagnosis of bacterial infections and have high feasibility as index for judging bacteria infection severity and antibiotics sensitivity
therefore worth clinical promotion.
降钙素原细菌感染超敏C反应蛋白
procalcitoninBacterial infectionhigh sensitivity C-reactive protein
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