多指标检测对于复杂性上尿路感染导致尿脓毒血症的价值分析

发布时间：2018-04-25 14:18

本文选题：降钙素原 + C-反应蛋白　；参考：《中华医院感染学杂志》2017年02期

【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)及白细胞计数(WBC)多指标检测对于复杂性上尿路感染导致尿脓毒血症的价值,以期为尿脓毒血症寻找早期鉴别诊断指标。方法选取2013年1月-2016年1月医院泌尿外科收治复杂性上尿路感染患者且术后并发尿脓毒血症患者84例为观察组,另选同期住院术后发生尿路感染患者60例为对照1组,同期住院脓毒血症患者60例为对照2组;观察组与对照2组确诊后抽血送检,对照1组确诊尿路感染后抽血送检;观察3组患者PCT、CRP、IL-6及WBC水平,根据脓毒血症严重程度及治疗结局将观察组及对照2组进行划分,观察不同严重程度及治疗结局患者观察指标水平变化。结果观察组各项观察指标均高于对照1组(P0.05),CRP、IL-6及WBC指标低于对照2组(P0.05),观察组与对照2组严重患者各项指标均高于同组非严重患者(P0.05),观察组不同程度患者CRP、IL-6及WBC指标水平均低于对照2组同程度(P0.05),观察组与对照2组死亡患者各项指标均高于同组存活患者(P0.05),观察组不同治疗结局患者CRP、IL-6及WBC指标水平低于对照2组同结局患者(P0.05);尿脓毒血症各项指标均呈正相关(P0.05),灵敏度及特异性依次为PCT、CRP、IL-6、WBC。结论 PCT、CRP、IL-6及WBC水平与尿脓毒血症病情均具有相关性,随病情程度增加而增高,PCT对疾病早期诊断具有重要意义,但对鉴别病源部位效果欠佳,联合检验PCT、CRP对复杂性上尿路感染导致的脓毒血症意义重大。
[Abstract]:Objective to investigate the value of multiple indexes of serum calcitonin proto PCTU C-reactive protein (CRP), interleukin-6 (IL-6) and white blood cell count (WBC6) in the diagnosis of urinary sepsis caused by complicated upper urinary tract infection, in order to find the early differential diagnostic index for urinary sepsis. Methods from January 2013 to January 2016, 84 patients with complicated upper urinary tract infection and complicated with urinary sepsis were selected as the observation group, and 60 patients with postoperative urinary tract infection in the same period were selected as the control group. In the same period, 60 patients with sepsis were selected as the control group, the patients in the observation group and the control group were given blood samples after diagnosis, and in the control group 1, the levels of IL-6 and WBC were observed after the diagnosis of urinary tract infection in the three groups. According to the severity of sepsis and the outcome of treatment, the observation group and the control group were divided into two groups. Results all the observed indexes in the observation group were higher than those in the control group 1 (P 0.05) and the WBC index was lower than that in the control group 2 (P 0.05). All the indexes in the observation group and the control group were higher than those in the control group (P 0.05). The levels of IL-6 and WBC finger in the observation group were higher than those in the control group (P 0.05). The standard level was lower than that of the control group (P 0.05), the indexes of the death patients in the observation group and the control group were higher than those in the same survival group (P 0.05). The levels of IL-6 and WBC in the patients with different therapeutic outcomes in the observation group were lower than those in the same outcome patients in the control group (P 0.05). All the indexes of urinary sepsis were positively correlated with P0.05, and the sensitivity and specificity were as follows: PCT CRP IL-6 and WBC. Conclusion the levels of IL-6 and WBC are correlated with the severity of urinary sepsis. It is important for the early diagnosis of the disease to increase with the increase of the severity of the disease, but it is not effective in differentiating the location of the disease. Combined detection of PCTU CRP is of great significance for sepsis caused by complicated upper urinary tract infection.
【作者单位】：郑州大学附属南阳市中心医院泌尿外科;南阳医学高等专科学校医教室;
【基金】：河南省卫生计生委科技攻关项目(201405011)
【分类号】：R691.3;R459.7

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