血清CRP、IL-6及PCT对胆道感染的诊断价值

发布时间：2018-05-14 07:54

本文选题：血清 + CRP　；参考：《中华医院感染学杂志》2017年02期

【摘要】：目的探讨血清C-反应蛋白(CRP)、白细胞介素-6(IL-6)和降钙素原(PCT)对胆道感染的诊断效果,为胆道感染早期诊断提供新的途径。方法选取2014年6月-2016年6月医院接受治疗的胆道感染患者103例为研究组,同期在医院做常规体检的健康者103例为对照组,比较两组受试者的一般资料、CRP、IL-6和PCT的含量,确定CRP、IL-6和PCT对胆道感染的曲线下面积(ROC)和诊断分界点,统计胆道感染的灵敏度、特异性、阳性与阴性的预测值,比较CRP、IL-6和PCT含量与病原微生物的关系。结果研究组总胆红素的含量显著高于对照组,差异有统计学意义(P0.05);103例胆道感染患者共分离培养121株菌落,其中,革兰阴性菌79株占65.3%,以大肠埃希菌、铜绿假单胞菌和肺炎克雷伯菌为主,革兰阳性菌19株占15.7%,以金黄色葡萄球菌为主,真菌23株占19.0%,以白假丝酵母菌为主;研究组受试者CRP、IL-6、PCT的含量显著高于对照组,且差异有统计学意义(P0.05);3种炎性因子均对胆道感染具有较好的预测作用,其中IL-6的敏感性(94.2%)最强,CRP的特异性(80.6%)最强,PCT的阳性预测值(80.8%)最高,IL-6的阴性预测值(91.3%)最高;革兰阴性菌患者、革兰阳性菌患者以及真菌患者的CRP、IL-6和PCT的差异均无统计学意义。结论早期胆道感染患者的CRP、IL-6、PCT的含量显著提升,IL-6、PCT对于检测早期胆道感染属于敏感性较高的炎性指标,可以应用于早期胆道感染的辅助诊断,值得临床推广,不能作为胆道感染的确诊指标。
[Abstract]:Objective to investigate the diagnostic effect of serum C-reactive protein (CRP), interleukin-6 (IL-6) and procalcitonin (PCT) in the diagnosis of biliary tract infection, and to provide a new approach for the early diagnosis of biliary tract infection. Methods 103 patients with biliary tract infection received hospital treatment from June 2014 to June 2016 were selected as study group and 103 healthy subjects who underwent routine physical examination in hospital as control group. The contents of CRPIL-6 and PCT were compared between the two groups. The sensitivity, specificity, positive and negative predictive values of CRPP-IL-6 and PCT for biliary tract infection were determined, and the relationship between the contents of IL-6 and PCT and pathogenic microorganisms was compared. Results the content of total bilirubin in the study group was significantly higher than that in the control group, and the difference was statistically significant in 103 patients with biliary tract infection. Among them, 79 strains of Gram-negative bacteria accounted for 65.3%. Pseudomonas aeruginosa and Klebsiella pneumoniae were dominant, Gram-positive bacteria accounted for 15.7strains, Staphylococcus aureus was the main strain, fungi accounted for 19.00.The content of CRPIL-6 PCT in the study group was significantly higher than that in the control group. There were significant differences among the three inflammatory factors in predicting biliary tract infection, of which the sensitivity of IL-6 was 94.2) the specificity of IL-6 was 80.6) the positive predictive value of IL-6 was 80.8) the negative predictive value of IL-6 was 91.3%. There was no significant difference in CRP- 6 and PCT between Gram-negative bacteria, Gram-positive bacteria and fungal patients. Conclusion the level of IL-6 / PCT in patients with early biliary tract infection is a sensitive inflammatory index for detecting early biliary tract infection, and it can be used in the auxiliary diagnosis of early biliary tract infection. It is worth popularizing in clinic. It cannot be used as a diagnostic indicator of biliary tract infection.
【作者单位】：浙江中医药大学附属第一医院肝胆外科;
【基金】：浙江省医药科技项目(20152993)
【分类号】：R575.7

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