急诊感染3项及血培养在重症感染中的诊断价值

目的探讨在急诊科发生严重感染的病例中,急诊感染3项血清降钙素原(PCT)、超敏C反应蛋白(hs-CRP)、白细胞介素-6(IL-6)]与血培养的方法学比较;探讨急诊感染3项及血培养在重症感染患者中的临床应用价值。方法收集该院2019年1-5月急诊严重感染患者(重症感染组)64例,局部感染患者(局部感染组)60例和同期健康者(健康对照组)40例作为研究对象。抽取所有研究对象静脉血做血培养,检测血清PCT、IL-6及全血hs-CRP水平,3项均以定量进行结果分析。以出院重症感染确诊为金标准,比较分析血培养及急诊感染3项对急诊重症感染的诊断价值。结果重症感染组急诊感染3项阳性率均明显高于局部感染组和健康对照组,差异均有统计学意义(P<0.05),PCT、hs-CRP及IL-6检测在重症感染组灵敏度分别为93.00%、96.00%、95.00%,特异度分别为78.00%、55.00%、66.00%,急诊感染3项联合检测和血培养在重症感染组灵敏度分别为97.29%、78.82%,特异度分别为98.71%、100.00%。结论急诊感染3项检测可以提高脓毒血症早期诊断的灵敏度和特异度,并且在判断病情严重程度及预后情况方面均存在重要临床价值,但若要用于指导临床及时、合理使用抗菌药物,尚需同时进行血培养。

Diagnostic value of three items of emergency infection and blood culture in severe infection

Objective To explore the methodology comparison between three items of emergency infection,including serum procalcitonin(PCT),high sensitivity C-reactive protein(hs-CRP),interleukin-6(IL-6)and blood culture in Department of Emergency,and to explore the clinical application value of three items of emergency infection and blood culture in patients with severe infection.Methods 64 patients with severe infection(severe infection group),60 patients with local infection(local infection group)and 40 healthy people(healthy control group)in the same period were collected as the study objects.Venous blood was collected from all subjects for blood culture.Serum PCT,IL-6 and hs-CRP were measured,and the results of three items were analyzed quantitatively.The diagnosis of severe infection was taken as the gold standard,and the diagnostic value of blood culture and three items of emergency infection were compared and analyzed.Results The positive rate of three items of emergency infection in severe infection group was significantly higher than those in local infection group and healthy control group,and the differences were statistically significant(P<0.05).The sensitivity of PCT,hs-CRP and IL-6 detection in severe infection group was 93.0%,96.0%and 95.0%respectively,and the specificity was 78.0%,55.0%and 66.0%respectively.The sensitivity of combined detection of three items of emergency infection and blood culture in the severe infection group was 97.29%and 78.82%,the specificity was 98.71%and 100%,respectively.Conclusion The three detections of emergency infection can improve the sensitivity and specificity of early diagnosis of sepsis,and have important clinical value in judging the severity and prognosis of sepsis.However,If it is used to guide clinical timely and rational use of antibiotics,blood culture should be carried out at the same time.