| 李玉玲,杨景峰,王志斌,杨玲玲,寇立臣,刘建军,卢 铭.血清PCT、CRP及内毒素在细菌性血流感染所致脓毒症患者中的早期诊断价值[J].,2017,17(22):4365-4368 |
| 血清PCT、CRP及内毒素在细菌性血流感染所致脓毒症患者中的早期诊断价值 |
| Early Diagnostic Value of Serum PCT,CRP and Endotoxin in Patients with Sepsis Induced by Bacterial Bloodstream Infection |
| 投稿时间：2016-11-12 修订日期：2016-11-30 |
| DOI：10.13241/j.cnki.pmb.2017.22.040 |
| 中文关键词: 脓毒症 血流感染 降钙素原 C反应蛋白 内毒素 |
| 英文关键词: Sepsis Bloodstream infection PCT CRP Endotoxin |
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| 中文摘要: |
| 摘要 目的：探究血清降钙素原（PCT）、C反应蛋白（CRP）及内毒素在细菌性血流感染所致脓毒症患者中的早期诊断价值。方法：回顾性分析2010年5月~2015年5月期间我院收治确诊的细菌性血流感染所致脓毒症患者123例，测定其血清PCT、CRP及内毒素水平，通过受试者工作特征曲线（ROC）曲线探究三者对细菌性血流感染所致脓毒症的诊断价值。结果：血样培养结果显示，123例细菌性血流感染所致脓毒症患者中存在感染G+菌35例，感染G-菌88例；G+菌组的血清PCT、CRP及内毒素水平明显低于G-菌组（P<0.05）；且G+菌组、G-菌组及所有细菌组患者三指标两两间均呈正相关关系（P<0.05）；ROC曲线显示，血清PCT、CRP和内毒素预测G+菌血流感染所致脓毒症患者的临界值分别为1.58 μg/L、95.25 mg/L与16.71 ng/L，其灵敏度和特异度别为（65.92%，88.37%）、（67.39%，84.38%）与（56.34%，78.93%），预测G-菌血流感染所致脓毒症患者的临界值分别为2.45 μg/L、79.45 mg/L与15.54 ng/L，其灵敏度和特异度别为（78.73%，97.13%）、（68.89%，92.38%）与（65.39%，95.33%）。结论：检测血清PCT、CRP、内毒素水平有利于鉴别G-菌和G+菌血流感染所致脓毒症患者，且敏感度、特异度均较高，可用于早期诊断细菌性血流感染所致脓毒症。 |
| 英文摘要: |
| ABSTRACT Objective: To explore the early diagnostic value of serum procalcitonin(PCT),C-reactive protein (CRP) and endotoxin in patients with sepsis caused by bacterial bloodstream infection. Methods: Retrospectively analyzed 123 cases of patients diagnosed with sepsis induced by bacterial bloodstream infection in our hospital from May 2010 to May 2015, detected their serum PCT, CRP and endotoxin levels, and analyzed the evaluation value of these three indexes for sepsis induced by bacterial bloodstream infection by receiver-operating characteristic curve(ROC). Results: Blood sample culture results showed that 123 cases of bacterial bloodstream infections caused by sepsis patients in the presence of infection of G+bacteria were 35 cases, G-bacteria infection of 88 cases; The levels of three index in the G+bacteria group were significantly lower than that in the G-bacteria group(P<0.05); The serum PCT, CRP and endotoxin levels was positive correlated with each other among G+bacteria group, G-bacteria group and all bacteria group; ROC curves showed that the cutoff value of serum PCT, CRP and endotoxin for diagnosis of patients with sepsis induced by G+bacteria bloodstream infection were 1.58 μg/L, 95.25 mg/L and 16.71ng/L, and their sensitivity and specificity were (65.92%, 88.37%), (67.39%, 84.38%) and(56.34%,78.93%) respectively; and the cutoff value for diagnosis of patients with sepsis induced by G- bacteria bloodstream infection were 2.45 μg/L, 79.45 mg/L and 15.54 ng/L, their sensitivity and specificity were(78.73%, 97.13%), (68.89%, 92.38%) and(65.39%,95.33%)respectively. Conclusion: Detecting the serum PCT,CRP and endotoxin levels is helpful to identify patients with sepsis induced by G+ or G-bacteria bloodstream infection, with high sensitivity and specificity, which can be used in the early diagnosis of sepsis induced by bacterial bloodstream infection. |
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