降钙素原与C反应蛋白联合检测在细菌感染中的应用

目的评价联合检测降钙素原（PCT）、C反应蛋白（CRP）水平的改变在细菌感染患者疗效观察及预后判断中的临床意义。方法对重症监护病房（ICU）的60例细菌感染患者血清PCT、CRP的含量及动态变化进行检测,同时将60例细菌感染患者分为重症感染组和局部感染组,并与病毒感染组进行分析比较。结果重症细菌感染组血清PCT、CRP浓度中位数分别为15.0μg/L和90.0 mg/L;局部细菌感染组血清PCT、CRP中位数分别为1.8μg/L和55.3 mg/L;重症感染组和局部感染组血清PCT、CRP浓度均明显升高,与病毒感染组比较,差异有统计学意义（P〈0.001）;经有效抗菌药物治疗后,细菌感染组患者PCT、CRP水平与治疗前比较,差异有统计学意义（P〈0.001）;重症感染组与局部感染组比较,差异亦有统计学意义（P〈0.001、0.05）;以PCT〉0.5μg/L为界,诊断细菌感染的敏感性为96.7%（58/60）,特异性为85.3%（29/34）;以CRP〉8 mg/L为界,诊断细菌感染的敏感性为96.7%（58/60）,特异性为73.5%（25/34）。结论血清PCT、CRP联合检测在细菌感染的早期诊断中有一定价值,动态监测PCT水平有助于评估治疗效果,协助临床判断病情的转归和恶化。

Application of the combined determination of serum procalcitonin and C reactive protein in patients with bacterial infection

Objective To evaluate the clinical significance of the combined determination of serum procalcitonin（PCT） and C reactive protein（CRP）in the curative effect and prognosis of bacterial infection.Methods Serum PCT and CRP levels and their dynamic change of 60 patients with bacterial infection in intensive care unit（ICU）were measured,and the results were analyzed and compared with those of virus infection.The patients with bacterial infection were classified into serious infection group and local infection group.Results The medians of PCT and CRP concentrations in serious infection group were 15.0 μg/L and 90.0 mg/L.The medians of PCT and CRP concentrations in local infection group were 1.8 μg/L and 55.3 mg/L.The levels of PCT and CRP in bacterial infection group increased significantly,and there were statistical significance between bacterial infection and virus infection（P0.001）.There was statistical significance of the levels of PCT and CRP in bacterial infection group between before and after the antibiotic treatment（P0.05）.There were statistical significances between serious infection group and local infection group（P0.001,0.05）.For the assessment of bacterial infection at cut-off value of PCT0.5 μg/L,the sensitivity was 96.7%（58/60） and the specificity was 85.3%（29/34）.For the assessment of bacterial infection at cut-off value of CRP8 mg/L,the sensitivity was 96.7%（58/60） and the specificity was 73.5%（25/34）.Conclusions The combined determination of serum PCT and CRP assists the early diagnosis,estimation and prognosis of bacterial infection.Monitoring dynamically PCT level will help to evaluate the curative effect.