摘要
目的探讨降钙素原(PCT)、C反应蛋白(CRP)、白细胞介素6(IL-6)联合(1,3)-β-D葡聚糖[(1,3)β-D-glucan,BDG]和半乳甘露聚糖(galactomannan,GM)检测在血流感染类型早期鉴别诊断中的临床应用价值。方法回顾性纳入我院2019年1-12月血培养阳性的住院患者124例。比较细菌与真菌感染患者PCT、CRP、IL-6、BDG和GM试验各指标的水平,并采用受试者工作曲线(ROC)评价各指标单独及联合检测对真菌血流感染诊断的价值。结果真菌组PCT、CRP和IL-6的水平明显低于细菌组(P<0.05),而BDG的水平明显高于细菌组(P<0.05)。PCT、CRP、IL-6和BDG单独诊断真菌血流感染的ROC曲线下面积(AUC)分别为0.859、0.718、0.800和0.843(P<0.05)。四项指标联合诊断的AUC为0.914,与单独CRP、IL-6、BDG的AUC比较,差异有统计学意义(P<0.05),与单独PCT的AUC比较差异无统计学意义(P>0.05)。结论PCT、CRP、IL-6、BDG水平可作为鉴别真菌与细菌血流感染的参考指标,且PCT和BDG的鉴别诊断价值更高。四项指标联合检测在早期鉴别诊断真菌与细菌血流感染中有一定临床价值。
Objective To investigate the clinical value of procalcitonin(PCT),C-reactive protein(CRP),interleukin-6(IL-6)combined with(1,3)-D-glucan(BDG)and galactomanannan(GM)in early differential diagnosis of bloodstream infections-Methods We retrospectively involved 124 hospitalized patients with positive blood cultures from January to December 2019.The levels of PCT,CRP,IL-6,BDG and GM test indexes were compared between bacteria group and fungus group,and the receiver operating curve(ROC)was used to evaluate the diagnostic value of each index and the combined detection in fungal bloodstream infections.Results The level of PCT,CRP and IL-6 in the fungus group was significantly lower than those in the bacteria group(P<0.05);while that of BDG in the fungus group was significantly higher than that in the bacterial group(P<0.05).The area under the ROC curve(AUC)of PCT,CRP,IL-6,and BDG alone for the diagnosis of fungal bloodstream infections was 0.859,0.718,0.8 and 0.843 respectively(P<0.05)but that of the combined diagnosis of the four indicators was 0.914.The comparison of AUC of CRP,IL-6,and BDG and that of the diagnosis value of the combined indicated statistical significance(P<0.05).Conclusion The level of PCT,CRP,IL-6 and BDG can be used as reference indicator to distinguish fungal and bacterial bloodstream infections,and the differential diagnosis value of PCT and BDG is higher.The combined detection of four indicators has certain clinical value in the early differential diagnosis of fungal and bacterial bloodstream infections.
作者
苗强
徐晓华
魏彬
白杨娟
张君龙
蔡蓓
牛倩
MIAO Qiang;XU Xiaohua;WEI Bin;BAI Yangjuan;ZHANG Junlong;CAI Bei;NIU Qian(Department of Medical Laboratory,the West China Hospital,Sichuan University,Chengdu 610041,China;不详)
出处
《实用医学杂志》
CAS
北大核心
2021年第1期96-100,共5页
The Journal of Practical Medicine
基金
四川省科技厅重点研发项目(编号:2019YFS0287)。
