3项炎症标志物检测在重症监护病房患者细菌感染中的诊断价值

目的评估炎症标志物降钙素原（PCT）、C反应蛋白（CRP）、白细胞计数（WBC）检测与重症监护病房（ICU）患者的相关性。方法收集50例ICU患者的血清，细菌感染组（78例）和非细菌感染组（22例）检测血PCT、CRP和WBC。结果与WBC相比，PCT和CRP的中位值（Median）在细菌和非细菌感染两组中差异都有统计学意义。对于早期探测细菌感染，PCT有最高的敏感性，再结合临床参数及CRP检测其敏感性可达到100％。PCT曲线下的面积是0．859（95％CI，0．731～0．941），CRP0．761（95％CIO．619～0．870）、WBC0．611（95％CIO．463～0．746），PCT与CRP、WBC比较差异有统计学意义（P〈O．01）。诊断细菌和非细菌感染方面PCT比CRP、WBC有更高的敏感性和特异性。结论PCT在诊断ICU患者早期细菌感染比CRP和WBC有更好的应用价值。

Diagnostic value of PCT,CRP and WBC for bacterial infection of patients in ICU

Objective To evaluate the detection vaule of procalcitonin（PCT）, C-reactive protein（CRP） and leukocyte count（WBC） in patients at intensive care unit（ICU）. Methods Levels of PCT,CRP and WBC was detec- tion in 78 cases of patients with bacterial infection and 22 cases of patients with non bacterial infection. Results Me- dian values of PCT and CRP were with statistical difference between the two groups. PCT was the most sensitive for bacterial infection,and the diagnostic sensitivity could reach 100%, when being detected with clinical indexes and CRP. Areas under ROC curve of PCT was 0. 859（95% CI：O. 731--0. 941） ,higher than the 0. 761（95% CI：0. 619 0. 870） of CRP and the 0. 611（95% CI：O. 463--0. 746） of WBC（P〈0.05）. PCT level was more sensitive and specif ic,compared with CRP and WBC,for the differential diagnosis of bacterial and nob bacterial infections. Conclusion PCT could be with more clinical value than CRP and WBC for the early diagnosis of bacterial infection.