PCT、IL-6 及CRP 对脓毒症的诊断价值

目的 探究PCT、IL-6 及CRP 对脓毒症的诊断价值。方法 选取2015 年1 月-2016 年7 月 于南通大学附属医院收治的45 例脓毒症患者。分析对比患者的PCT、IL-6、CRP、血浆可溶性髓样细胞 触发受体-1（sTREM-1）、D- 二聚体、乳酸（Lac）及急性生理与慢性健康评分（APACHE Ⅱ），应用非 条件Logistic 逐步回归模型进行单因素和多因素的统计分析，绘制ROC 并比较PCT、IL-6 及CRP 对于 脓毒症的诊断效能。结果 单因素分析结果显示年龄、体温、性别比例、白细胞、中性粒细胞、中性粒细 胞比例、血小板、D- 二聚体及脑钠肽与脓毒症病情严重程度无相关性（P >0.05）；而APACHE Ⅱ评分、 CRP、IL-6、Lac、sTREM-1、PCT 与肺炎病情程度有相关性（P <0.05）。Logistic 逐步回归分析显示PCT、 APACHE II、sTREM-1、CRP、Lac 及IL-6 为诊断脓毒症的独立因素（P <0.05）。PCT 曲线下面积最大。 结论 PCT、IL-6 及CRP 对脓毒症具有较高的诊断价值，值得临床推广。

Value of PCT, IL-6 and CRP in diagnosis of sepsis

Objective To explore the diagnostic value of procalcitonin (PCT), IL-6 and CRP in sepsis. Methods Forty-five patients with sepsis in Affiliated Hospital of Nantong University, from January 2015 to July 2016 were selected. PCT, IL-6, C-reactive protein (CRP), plasma soluble myeloid cell trigger receptor-1 (sTREM-1), D-dimer, lactic acid (Lac), and Acute Physiology and Chronic Health Evaluation (APACHE II) scores of the patients were analyzed and compared. Univariate and multivariate statistical analyses were performed using unconditional logistic stepwise regression model, and ROC was drawn and the diagnostic efficacy of PCT, IL-6 and CRP for sepsis was compared. Results Age, body temperature, sex ratio, white blood cell count, neutrophil count, neutrophil ratio, platelets, D-dimer and brain natriuretic peptide were not correlated with sepsis severity (P > 0.05); and APACHE II scores, CRP, IL-6, Lac, sTREM-1 and PCT were correlated with the severity of pneumonia (P < 0.05). PCT, APACHE II scores, sTREM-1, CRP, Lac and IL-6 were the independent factors in the diagnosis of sepsis (P < 0.05). The area under the PCT curve was the largest. Conclusions PCT, IL-6 and CRP have high diagnostic value for sepsis and are worth promoting.