常用炎性指标对感染性疾病的诊断价值

目的 探讨临床常用炎性指标对感染性疾病的诊断价值.方法 检测脓毒症、病毒性感染、肺结核和淋病各100例患者的降钙素原(PCT)、C-反应蛋白(CRP)、结合珠蛋白(HP)、铜蓝蛋白(CER)α1-酸性糖蛋白(α1-AAG)α1-抗胰蛋白酶(α1-AAT)、WBC和红细胞沉降率(ESR),根据受试者工作特征曲线(ROC曲线),确定各项指标在诊断感染性疾病的最佳临界值,并计算各项炎性指标的灵敏度、特异度、阳性预测值、阴性预测值、约登指数、阳性似然比、阴性似然比及总符合率.结果 PCT在脓毒症患者中的ROC曲线下面积、灵敏度、特异度、约登指数、阳性似然比、阳性预测值和总符合率分别是0.895、0.84、0.92、0.76、10.50、0.91和0.88,其诊断价值均优于CRP、HP、CER、α1-AAG、α1-AAT、WBC和ESR.结论 PCT优于目前临床应用的炎性反应参数,可作为严重细菌感染早期的快速、敏感的检测手段之一.

Diagnostic value of common inflammatory markers in patients with infectious diseases

Objective To study the diagnostic value of common inflammatory markers in patients with infectious diseases. Methods One hundred sepsis patients, 100 viral infection patients,100 pulmonary tuberculosis patients and 100 gonorrhea patients were analyzed retrospectively. The contents of procalcitonin (PCT), C-reactive protein (CRP), haptoglobin (HP), ceruloplasmin (CER), α1-acid glycoprotein (α1-AAG), α1-antitrypsin (α1-AAT), white blood cell count (WBC) and erythrocyte sedimetation rate (ESR) were measured. The receiver operating characteristic curve (ROC curve), sensitivity, specificity, positive predictive value, negative predictive value, Youden's index,positive and negative likelihood ratios and total coincidence rate were calculated respectively. Results The area under the ROC curve, sensitivity, specificity, Youden's index and positive likelihood ratios,positive predictive value and total coincidence rate of PCT in sepsis patients were 0. 895, 0.84, 0.92,0.76, 10.50, 0.91 and 0.88, respectively, which were superior to CRP, HP, CER, α1-AAG, α1-AAT, WBC and ESR. Conclusions PCT is a better inflammatory reactive parameter than other parameters currently applied in practice and may serve as a rapid and sensitive test in the early stage of severe bacterial infections.