菌血症患者细菌感染程度与血清PCT、hs-CRP水平变化研究

发布时间：2018-07-04 19:51

本文选题：降钙素原 + 细菌感染　；参考：《重庆医科大学学报》2017年02期

【摘要】：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(P0.05);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(P0.05)。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(P0.05)。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。
[Abstract]:Objective: To explore the specificity of procalcitonin (PCT) and hypersensitive C reactive protein (high sensitivity C-reactive protein, hs-CRP) in the diagnosis of bacterial infection, and to explore the feasibility of judging the severity of bacterial infection and the sensitivity index of antibiotic treatment. Methods: the patients admitted from July 2013 to July 2015 were selected as research subjects. The results of the laboratory blood culture were 20 cases of negative bacterial infection control group (group A), 120 cases of bacterial infection in laboratory blood culture, 40 cases of local bacterial infection group (group B), 40 cases of bacterial infectious SIRS group (group C), and 40 cases of sepsis group (group D). All cases of bacterial infection were treated with antibiotics. The serum PCT, hs-CRP level, treatment 24 h, 4 D, and 7 d were detected before, and PCT, hs-CRP level was detected again, and the variance analysis and ROC curve analysis were carried out. Results: the single factor variance analysis showed that the difference between PCT and hs-CRP in 4 groups was statistically significant (F=22.27, P=0.000; The level of bacterial infection in group D was higher than that in group A (P=0.000), but there was no significant difference between the 3 infection groups (P0.05). The level difference between 22 groups was statistically significant (P=0.000) for hs-CRP, A, B, C, D and 4 groups. The serum PCT level of patients with sepsis was significantly higher before the use of antibiotics and the bacterial infection was successful. After control, the serum PCT level of the patients decreased rapidly and reached the normal level, while the decrease of CRP was slower (P0.05). The diagnostic specificity (87.02%) and sensitivity (80.98%) of serum PCT detection for bacterial infectious diseases were higher than hs-CRP, and the difference was statistically significant (P0.05). Conclusion: serum PCT, hs-CRP level diagnosis of bacterial infection specificity, as The feasibility of bacterial infection severity and antibiotic treatment sensitivity index is high, which has guiding significance for clinical practice and is worthy of clinical promotion.
【作者单位】：重庆市红十字会医院/江北区人民医院;
【基金】：重庆市卫计委资助项目(编号:20142160)
【分类号】：R515.3

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