血清PCT、CRP水平及WBC检测对急诊血流感染的鉴别诊断价值

目的探讨血清降钙素原(PCT)、C反应蛋白(CRP)水平及白细胞计数(WBC)检测对急诊血流感染的鉴别诊断价值。方法选择2019年1月至2020年1月我院接收的124例血流感染患者,按照血培养结果将其分成阳性组(65例)与阴性组(59例),均给予血培养、PCT、CRP水平及WBC检测,将阳性组患者按照血培养物的革兰染色结果分成革兰阴性菌(G-菌)组(42例)与革兰阳性菌(G+菌)组(23例)。比较不同组别的PCT、CRP水平及WBC。结果阳性组的PCT、CRP、WBC阳性率相比,差异无统计学意义(P>0.05)。阴性组的PCT阳性率显著低于CRP、WBC阳性率(P<0.05)。阳性组的PCT阳性率显著高于阴性组(P<0.05)。两组的CRP、WBC阳性率比较,差异无统计学意义(P>0.05)。阳性组的PCT、CRP水平及WBC均显著高于阴性组(P<0.05)。G-菌组的PCT水平明显高于G+菌组(P<0.05)。G-菌组和G+菌组的CRP水平及WBC无显著差异(P>0.05)。结论在急诊血流感染鉴别中,PCT、CRP水平及WBC的检测均可发挥一定的指导价值,但PCT的血流感染阳性率、判别革兰阴阳性致病菌的能力优于CRP及WBC,必要时,可将3项指标联用,以提升临床诊断的准确性。

Differential diagnosis value of serum PCT,CRP levels and WBC detection in emergency bloodstream infection

Objective To explore the differential diagnosis value of serum procalcitonin(PCT),C-reactive protein(CRP)levels and white blood cells count(WBC)detection in emergency bloodstream infections.Methods A total of 124 patients with bloodstream infection received in our hospital from January 2019 to January 2020 were selected and divided into positive group(65 cases)and negative group(59 cases)according to the blood culture results.All patients were given blood culture,PCT,CRP levels and WBC detection.According to the Gram staining results of blood culture,the patients in the positive group were divided into Gram-negative bacteria(G-bacteria)group(42 cases)and Gram-positive bacteria(G+bacteria)group(23 cases).The PCT,CRP levels and WBC in the different groups were compared.Results There was no significant difference in the positive rates of PCT,CRP and WBC in the positive group(P>0.05).The positive rate of PCT in the negative group were significantly lower than that of CRP and WBC(P<0.05).The positive rate of PCT in the positive group was significantly higher than that in the negative group(P<0.05).There were no significant differences in the positive rates of CRP and WBC between the two groups(P>0.05).The PCT,CRP levels and WBC in the positive group were significantly higher than those in the negative group(P<0.05).The PCT level in the G-bacteria group was significantly higher than that in the G+bacteria group(P<0.05).There were no significant differences in CRP level and WBC between the G-bacteria group and the G+bacteria group(P>0.05).Conclusion PCT,CRP levels and WBC detection can play a certain guiding value in the identification of emergency bloodstream infection,but the positive rate of bloodstream infection and the ability to distinguish Gram-positive and Gram-negative pathogens of PCT are better than the CRP and WBC.If necessary,the three indexes can be combined to improve the accuracy of clinical diagnosis.