降钙素原与高敏C反应蛋白联合检测在老年冠心病患者细菌感染中的临床应用

目的比较冠心病患者血液感染性指标的变化，分析降钙素原（PCT）和高敏C反应蛋白(hs CRP)在患者细菌感染中的临床诊断价值。方法选择2013年1月—2014年12月某院收治的冠心病患者，分别于治疗前（D0天）和治疗后第5天（D5）对诊断感染指标PCT、hs CRP、全血白细胞计数（WBC）、中性粒细胞计数（NEU）进行检测，比较细菌感染与非细菌感染组之间的差异，不同部位细菌感染，以及存活组和死亡组之间的差异。结果细菌感染组四项检测指标（PCT、hs CRP、WBC和NEU）均明显高于非细菌感染组；不同感染部位血清PCT和hs CRP水平比较，差异均具有统计学意义（均P<0.001），其中以血流感染患者水平最高［分别为（45.148±46.341）ng/mL、（137.000±87.367）mg/L］，其次是胸腹腔感染和呼吸系统感染，泌尿系统感染患者最低［分别为（0.769±1.747）ng/mL、（53.006±45.450）mg/L］。存活组经治疗后各项检测指标均较治疗前低，而死亡组则不断增高。冠心病合并细菌感染患者血清PCT、hs CRP、WBC和NEU曲线下面积分别是0.934、0.856、0.782和0.784。结论联合检测血清PCT和hs CRP不仅可作为鉴别老年冠心病患者早期细菌感染的有效指标，还可用于病情评估，疗效判断，对评估感染的严重程度以及对患者预后的判断具有重要意义。

Clinical application of combined detection of procalcitonin and high sensitivity C reactive protein in bacterial infection in elderly patients with coronary heart disease

ObjectiveTo compare changes in infectious markers in blood of patients with coronary heart disease (CHD), analyze clinical diagnostic value of procalcitonin (PCT) and high sensitivity C reactive protein (hs CRP) in bacterial infection in patients with CHD. MethodsPatients with CHD admitted to a hospital between January 2013 and December 2014 were studied. PCT, hs CRP, white blood cell (WBC), and neutrophil (NEU) count were detected before treatment and on the 5th day after treatment, differences between bacterial infected group and non infected group, infection sites, as well as survival and death groups were compared respectively. ResultsSerum levels of PCT,hs CRP,WBC, and NEU in bacterial infected group were all significantly higher than non infected group; PCT and hs CRP in infection of different sites were statistically significant （all P<0.001）, patients with bloodstream infection had the highest levels (［45.148±46.341］ ng/mL, ［137.000±87.367］mg/L, respectively)，followed by thoracic and abdominal infection,as well as respiratory system infection，while patients with urinary system infection had the lowest levels(［0.769±1.747］ng/mL, ［53.006±45.450］mg/L, respectively). After treatment, makers in survival group were all lower than before treatment, but in death group were all higher than before treatment. The area under the curve of PCT, hs CRP, WBC, and NEU were 0.934, 0.856, 0.782, and 0.784 respectively. ConclusionThe combined detection of PCT and hs CRP is effective for early diagnosis of bacterial infection in elderly patients with CHD, it is also helpful for assessing disease condition, curative efficacy, and prognosis.