摘要
目的:分析降钙素原(Procalcitonin,PCT)、白细胞介素-6(Interleukin-6,IL-6)、C反应蛋白(C-reactive protein,CRP)、血清淀粉样蛋白a(Serum amyloid a,SAA)联合早期诊断细菌性血流感染的临床应用价值。方法:回顾性分析2020年1月至2023年12月宁乡市中医医院的237例疑似为细菌性血流感染患者的临床资料,依照血培养病原菌检测结果分为细菌感染组和对照组。比较两组血清PCT、IL-6、CRP、SAA水平,分析血清PCT、IL-6、CRP、SAA及联合检查对细菌性血流感染的早期诊断价值。结果:237例疑似为细菌性血流感染患者中,血培养阳性患者占比为74.68%(177/237),血培养阴性患者占比为25.32%(60/237)。细菌感染组血清PCT、IL-6、CRP、SAA水平均高于对照组(P<0.05)。血清PCT、IL-6、CRP、SAA水平及联合检测曲线AUC大于参考线(AUC>0.5),血清PCT、IL-6、CRP、SAA、联合检测曲线AUC分别为0.731、0.703、0.590、0.686、0.839,95%CI分别为0.670~0.786、0.641~0.761、0.525~0.654、0.623~0.745、0.786~0.884,敏感度分别为0.418、0.593、0.260、0.565、0.729,特异度分别为0.967、0.767、0.950、0.917、0.850,cut-off值分别为4.77ng·mL^(-1)、126.51pg·mL^(-1)、144.18mg·L^(-1)、406.81mg·L^(-1)。结论:血清PCT、IL-6、CRP、SAA联合检测可早期诊断细菌性血流感染,且联合检测敏感度高于单项检测。
Objective:To analyze the clinical application value of combination of procalcitonin(PCT),interleukin-6(IL-6),C-reactive protein(CRP)and serum amyloid a(SAA)in the early diagnosis of bacterial bloodstream infection.Methods:The clinical data of 237 patients with suspected bacterial bloodstream infection in ningxiang traditional chinese medicine hospital were retrospectively analyzed from January 2020 to December 2023.According to the detection results of pathogenic bacteria in blood culture,the patients were divided into bacterial infection group and control group.The levels of serum PCT,IL-6,CRP and SAA were compared between groups,and the early diagnostic value of serum PCT,IL-6,CRP,SAA and combined examination on bacterial bloodstream infection was analyzed.Results:Among the 237 patients with suspected bacterial bloodstream infection,the proportions of patients with positive blood culture and patients with negative blood culture were 74.68%(177/237)and 25.32%(60/237).The levels of serum PCT,IL-6,CRP and SAA in bacterial infection group were higher than those in control group(P<0.05).The AUCs of serum PCT,IL-6,CRP,SAA and combined detection were higher than the reference line(AUC>0.5),the AUC of Serum PCT,IL-6,CRP,SAA and combined detection were 0.731,0.703,0.590,0.686 and 0.839 respectively,95%CI were 0.670-0.786,0.641-0.761,0.525-0.654,0.623-0.745 and 0.786-0.884 respectively,the sensitivity was 0.418,0.593,0.260,0.565,0.729 respectively,and the specificity was 0.967,0.767,0.950,0.917 and 0.850 respectively,serum PCT,IL-6,CRP and SAA the cut-off values were 4.77ng·mL^(-1),126.51pg·mL^(-1),144.18mg·L^(-1) and 406.81mg·L^(-1) respectively.Conclusion:The combined detection of serum PCT,IL-6,CRP and SAA can early diagnose the bacterial bloodstream infection,and the sensitivity of combined detection is higher than that of single detection.
作者
胡沩
张彬
Hu Wei;Zhang Bin(Ningxiang Traditional Chinese Medicine Hospital,Changsha 410006,China)
