降钙素原与C反应蛋白在尿脓毒血症早期诊断价值的临床研究

发布时间：2018-05-28 01:11

本文选题：降钙素原 + C反应蛋白　；参考：《青海大学》2016年硕士论文

【摘要】：目的:探讨降钙素原(procalcitonin,PCT)、C反应蛋白(C-reactive protein,CRP)的检测在尿脓毒血症早期诊断过程中临床价值,以期对尿脓毒血症患者早期诊断,给予及时有效的干预措施,改善患者预后,降低其病死率。方法:收集青海省人民医院泌尿外科住院部自2014年01月起至2015年12月间收治的132例尿路感染患者资料,其中诊断为尿脓毒血症的患者38例为研究组,诊断为非脓毒血症普通泌尿道感染患者94例为对照组。回顾性分析入选患者发热早期测定血清PCT、CRP、白细胞、中性粒细胞的水平,两组数据分析比较,并通过统计学软件Medcal对PCT、CRP等指标绘制受试者工作特征曲线(ROC曲线),计算PCT与CRP的最佳截断值及各炎症指标曲线下面积(area under the curve,AUC),比较各检测相关炎症指标对早期诊断尿脓毒血症的敏感度、特异度和准确性。结果:尿脓毒血症组与普通尿路感染组相比较,血清PCT、CRP、白细胞及中性粒细胞的水平明显高(P0.05),差别有统计学意义。通过绘制两组患者PCT与CRP的ROC曲线,PCT与CRP分别取值为1.76ng/ml、12.1mg/L时两者AUC分别为0.976、0.861,敏感度分别为95.8%、92.1%,特异度分别为88.3%、43.6%。结论:1.血清PCT与CRP对尿脓毒血症患者早期诊断具有较大的临床价值;2.血清PCT与CRP相比较,敏感度和特异度均较高,且AUC值较大,提示PCT在尿脓毒血症早期诊断的准确性更高。
[Abstract]:Objective: to investigate the clinical value of the detection of procalcitonin (procalcitonin) C-reactive protein (CRP) in the early diagnosis of urinary sepsis, and to provide timely and effective intervention measures to improve the prognosis of patients with urinary sepsis. Reduce the case fatality rate. Methods: 132 patients with urinary tract infection were collected from January 2014 to December 2015 in Department of Urology, people's Hospital of Qinghai Province. 94 patients with common urinary tract infection were diagnosed as control group. The serum levels of CRP, leukocytes and neutrophils in patients with fever were measured in the early stage of fever, and the data of the two groups were analyzed and compared. The operating characteristic curve of subjects was drawn by statistical software Medcal. The optimum truncation value of PCT and CRP and the area under each inflammatory index curve were calculated. The relative inflammation indexes were compared for early diagnosis. Sensitivity to sepsis, Specificity and accuracy. Results: the serum levels of CRP, leukocytes and neutrophils in urinary sepsis group were significantly higher than those in common urinary tract infection group (P 0.05). By drawing the ROC curve of PCT and CRP in the two groups, the values of ROC and CRP were 1.76 ng / ml / L and 12.1mg / L, respectively. The AUC of the two groups was 0.976mg / L, the sensitivity was 95.8g / 92.1, and the specificity was 88.3mg / L, respectively. Conclusion 1. Serum PCT and CRP have great clinical value in the early diagnosis of urinary sepsis. Compared with CRP, serum PCT had higher sensitivity and specificity, and higher AUC value, which suggested that PCT was more accurate in the early diagnosis of urinary sepsis.
【学位授予单位】：青海大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R459.7

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