摘要
目的探讨降钙素原(PCT)、C反应蛋白(CRP)、白细胞计数(WBC)和中性粒细胞百分比(NEU%)在血流感染诊断中的应用价值。方法回顾性分析2018年1月至2020年1月于深圳市罗湖医院集团治疗的血培养阳性患者134例(血培养阳性组)及血培养阴性患者109例(血培养阴性组)的PCT、CRP、WBC、NEU%检测结果,比较2组及血培养阳性组中革兰阳性菌及革兰阴性菌感染者4项指标的结果,绘制受试者工作特征曲线(ROC曲线),评价PCT、CRP、WBC、NEU%单项及联合检测对血流感染的诊断价值。结果134株病原菌中革兰阳性菌57株(42.5%),以金黄色葡萄球菌、肠球菌属为主;革兰阴性菌77株(57.5%),以大肠埃希菌、肺炎克雷伯菌为主。血培养阳性组PCT、CRP、WBC、NEU%明显高于血培养阴性组,差异有统计学意义(P<0.05)。血培养阳性组中革兰阴性菌感染者PCT水平明显高于革兰阳性菌感染者,差异有统计学意义(P<0.05);而CRP、WBC、NEU%差异无统计学意义(P>0.05)。PCT、CRP、WBC、NEU%单项检测诊断血流感染患者的曲线下面积(AUC)分别为0.849、0.749、0.727、0.833;PCT、CRP、WBC、NEU%联合检测的AUC为0.895。结论PCT、CRP、WBC、NEU%4项指标均能有效诊断血流感染,其中PCT单项检测的AUC最大,辅助诊断价值较CRP、WBC、NEU%高,且PCT可较好地区分细菌感染类型;PCT、CRP、WBC、NEU%联合检测可提高对血流感染患者的诊断价值。
Objective To investigate the value of procalcitonin(PCT),C-reactive protein(CRP),white blood cell count(WBC)and neutrophil percentage(NEU%)in early diagnosis of bloodstream infection.Methods The PCT,CRP,WBC and NEU%test results of 134 blood culture positive patients(blood culture positive group)and 109 blood culture negative patients(blood culture negative group)treated in Shenzhen Luohu Hospital Group from January 2018 to January 2020 were retrospectively analyzed.The results of four indicators of Gram-positive and Gram-negative bacteria infection in the blood culture positive group and the two groups were compared,and the receiver operating characteristic curve(ROC curve)was drawn to evaluate the diagnostic efficacy of PCT,CRP,WBC,NEU%single and combined detection for bloodstream infection.Results Of the 134 strains pathogens isolated,57 strains(42.5%)were Gram-positive,mainly Staphylococcus aureus and Enterococcus;77 strains(57.5%)were Gram-negative,mainly Escherichia coli and Klebsiella pneumoniae.The results of PCT,CRP,WBC and NEU%in the blood culture positive group were significantly higher than those in the blood culture negative group(P<0.05).The PCT level of blood culture negative group was significantly higher than that of blood culture positive group,the difference was statistically significant(P<0.05),but the CRP,WBC,NEU%were not statistically significant(P>0.05).The area under the curve(AUC)of PCT,CRP,WBC and NEU%single detection in the diagnosis of bloodstream infection was 0.849,0.749,0.727 and 0.833 respectively;the AUC of PCT,CRP,WBC and NEU%combined detection was 0.895.Conclusion PCT,CRP,WBC,NEU%can effectively diagnose bloodstream infection disease,PCT single detection of AUC is the largest,auxiliary diagnostic value is higher than CRP,WBC,NEU%,and PCT can better distinguish the type of bacterial infection;combined detection of PCT,CRP,WBC,NEU%can improve the diagnostic value of bloodstream infection patients.
作者
钟小珍
韦洁宏
王萌萌
蔡毅华
刘丽亚
张秀明
豆小文
ZHONG Xiaozhen;WEI Jiehong;WANG Mengmeng;CAI Yihua;LIU Liya;ZHANG Xiuming;DOU Xiaowen(Department of Clinical Laboratory,Shenzhen Luohu People′s Hospital,Shenzhen,Guangdong 518000,China;School of Medicine,Anhui University of Science and Technology,Huainan,Anhui 232001,China)
出处
《国际检验医学杂志》
CAS
2021年第9期1025-1028,共4页
International Journal of Laboratory Medicine
基金
国家自然科学基金面上项目(81872076)
广东省深圳市卫生和计划生育委员会学科建设能力提升项目(SZXJ2017018)
广东省深圳市医疗卫生三名工程项目(SZSM201601062)
广东省深圳市医学重点学科建设经费项目(SZXK054)。
关键词
血流感染
降钙素原
C反应蛋白
白细胞计数
中性粒细胞百分比
bloodstream infection
procalcitonin
C-reactive protein
white blood cell count
neutrophil percentage
