| 马雪平,郝钦芳,刘兰兰,张 景,张小丽,马伏英.PCT与IL-6联合检测鉴别诊断脓毒性和非脓毒性全身炎症反应综合征的临床价值[J].,2017,17(26):5124-5127 |
| PCT与IL-6联合检测鉴别诊断脓毒性和非脓毒性全身炎症反应综合征的临床价值 |
| The Clinical Value of Combined Detection of PCT and IL-6 in the Differential Diagnosis Septic and Non-septic SIRS in ICU |
| 投稿时间：2017-04-07 修订日期：2017-04-27 |
| DOI：10.13241/j.cnki.pmb.2017.26.027 |
| 中文关键词: 降钙素原 白细胞介素-6 全身炎症反应综合征 脓毒症 鉴别诊断 |
| 英文关键词: Procalcitonin Interleukin-6 Systemic inflammatory response syndrome Sepsis Differential diagnosis |
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| 摘要 目的：探讨降钙素原(PCT)与白细胞介素-6(IL-6)联合检测鉴别诊断ICU患者脓毒性和非脓毒性全身炎症反应综合征(SIRS)的临床价值。方法：选择2013年~2016年入住我院ICU的100例患者，包括61例非脓毒性SIRS患者与39例脓毒症患者，同时选择同期50例健康者作对照，分别设为非脓毒性组、脓毒血症组及对照组，采用电化学发光分析法检测三组血清PCT与IL-6水平，并以PCT为2 μg/L和IL-6为50 ng/L为临界值来鉴别非感染性SIRS和脓毒血症，评价联合检测的临床诊断价值。结果：非脓毒性组PCT与IL-6最大值分别为0.91±0.54μg/L、62.77±11.75 ng/L，脓毒血症组为24.49±5.00 μg/L、1542.69±361.66 ng/L，对照组为0.08±0.06 μg/L、3.68±1.11 ng/L，非脓毒性组与脓毒血症组PCT与IL-6最大值均显著高于对照组(P＜0.05)；与非脓毒性组比较，脓毒血症组PCT与IL-6均显著升高(P＜0.05)。非脓毒性组PCT＞2 μg/L、IL-6＞50 ng/L的占比分别为21.31%、65.57%，脓毒血症组为92.31%、87.18%，脓毒血症组PCT＞2 μg/L、IL-6＞50 ng/L的占比均显著提高于非脓毒性组(P＜0.05)。PCT的阳性预期值、灵敏度、特异度均显著高于IL-6，而联合检测的阳性预期值、特异度显著高于IL-6及PCT，联合检测的灵敏度显著高于IL-6，P均<0.05。结论：PCT与IL-6联合检测有助于脓毒性和非脓毒性SIRS的鉴别诊断。 |
| 英文摘要: |
| ABSTRACT Objective: To explore the value of combined detection of PCT and IL-6 in differential diagnosis SIRSin ICU patients. Methods: 100 patients with ICU admitted to our hospital from 2013 to 2016 were choosen, including 61 cases with non septic SIRS and 39 cases with sepsis, and 50 healthy persons over the same period were selected as control, and they were divided into non-septic group, sepsis group and control group. The levels of serum PCT and IL-6 were detected by electrochemiluminescence assay, and took PCT of 2 g/L and IL-6 of 50 ng/L for the critical value to identify non infectious SIRS and sepsis, to evaluate the clinical diagnostic value of com- bined detection. Results: The maximum values of PCT and IL-6in the non-septic group respectively were 0.91±0.54 μg/L and 62.77±11.75 ng/L, in the septic group respectively were 24.49±5.00 μg/L and 1542.69±361.66 ng/L, in the control group respectively were 0.08±0.06 μg/L and 3.68±1.11 ng/L, the maximum values of PCT and IL-6 in the non-sepsis group and the sepsis group were signifi- cantly higher than control group (P<0.05). Compared with the non-septic group, the maximum valuesin sepsis group were significantly increased (P<0.05). The proportions of PCT＞2 g/L and IL-6＜50ng/L in the non-septic group respectively were 21.31% and 65.57%, in the septic group respectively were 92.31% and 87.18%, the proportions of PCT＞2 g/L, IL-6＜50 ng/L in the sepsis groupwere signifi- cantly higher chan those in the non-septic group(P<0.05). The positive predictive values, sensitivity and specificity of PCT were higher than IL-6, the positive value, specificity of combined detection was higher than IL-6 and PCT, while the sensitivity of combined detection was higher than IL-6, P<0.05. Conclusion: Combined detection of PCT and IL-6 is helpful for differential diagnosis of sepsis and non-septic SIRS. |
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