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通过降钙素原(PCT)、C反应蛋白(CRP)和白细胞介素-6(IL-6)的实验室分析对脓毒症患者的细菌感染进行早期诊断。

Early diagnosis of bacterial infection in patients with septicopyemia by laboratory analysis of PCT, CRP and IL-6.

作者信息

Gao Liqin, Liu Xinghui, Zhang Denghai, Xu Fengxia, Chen Qing, Hong Ye, Feng Gang, Shi Qin, Yang Bin, Xu Limin

机构信息

Department of Laboratory Medicine, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian 350004, P.R. China.

Department of Clinical Laboratory, Shanghai Gongli Hospital, The Second Military Medical University, Shanghai 200135, P.R. China.

出版信息

Exp Ther Med. 2017 Jun;13(6):3479-3483. doi: 10.3892/etm.2017.4417. Epub 2017 May 3.

Abstract

The aim of the present study was to investigate the early diagnostic values of measuring procalcitonin (PCT), C-reactive protein (CRP), and interleukin-6 (lL-6) levels in patients with bacterial infections and septicopyemia. Ninety-two patients with septicopyemia who were diagnosed and treated in the First Affiliated Hospital of Fujian Medical University between December 2012 and October 2013 were randomly selected. Based on results of hemoculture, the patients were divided into the Gram-negative bacterial infection group (n=47) and the Gram-positive bacterial infection group (n=45). Immune nephelometry was used for measuring serum CRP levels, electrochemiluminescence assay was used to measure serum PCT and IL-6. The levels of serum CRP, PCT, and IL-6 in the Gram-negative bacterial infection group were significantly higher than in the Gram-positive group. Analysis with Spearman's correlation coefficient showed that there were positive correlations between the levels of PCT and CRP, and between PCT and IL-6 (P<0.05). The diagnosis of Gram-negative bacterial infections was as follows: The area under the PCT curve was 0.974 (P<0.05) with sensitivity and specificity of 96.8 and 93.5%, respectively. The area under the CRP curve was 0.953 (P<0.05) with sensitivity and specificity of 94.2 and 91.7%, respectively. The area under the IL-6 curve was 0.925 (P<0.05) with sensitivity and specificity of 93.6 and 90.5%, respectively. The diagnosis of Gram-negative bacterial infections was as follows: The area under the PCT curve was 0.854 (P<0.05) with sensitivity and specificity of 92.7 and 91.8%, respectively. The area under the CRP curve was 0.832 (P<0.05) with sensitivity and specificity of 90.2 and 89.3%, respectively. The area under the IL-6 curve was 0.817 (P<0.05) with sensitivity and specificity of 89.4 and 81.5%, respectively. In conclusion, PCT, CRP, and lL-6 can act as early diagnostic markers for bacterial infections in patients with septicopyemia.

摘要

本研究旨在探讨检测降钙素原(PCT)、C反应蛋白(CRP)及白细胞介素-6(IL-6)水平对细菌感染及脓毒症患者的早期诊断价值。随机选取2012年12月至2013年10月在福建医科大学附属第一医院确诊并治疗的92例脓毒症患者。根据血培养结果,将患者分为革兰阴性菌感染组(n = 47)和革兰阳性菌感染组(n = 45)。采用免疫比浊法检测血清CRP水平,用电化学发光法检测血清PCT和IL-6。革兰阴性菌感染组血清CRP、PCT及IL-6水平显著高于革兰阳性菌感染组。Spearman相关系数分析显示,PCT与CRP水平之间以及PCT与IL-6水平之间呈正相关(P<0.05)。革兰阴性菌感染的诊断结果如下:PCT曲线下面积为0.974(P<0.05),敏感性和特异性分别为96.8%和93.5%。CRP曲线下面积为0.953(P<0.05),敏感性和特异性分别为94.2%和91.7%。IL-6曲线下面积为0.925(P<0.05),敏感性和特异性分别为93.6%和90.5%。革兰阳性菌感染的诊断结果如下:PCT曲线下面积为0.854(P<0.05),敏感性和特异性分别为92.7%和91.8%。CRP曲线下面积为0.832(P<0.05),敏感性和特异性分别为90.2%和89.3%。IL-6曲线下面积为0.817(P<0.05),敏感性和特异性分别为89.4%和81.5%。总之,PCT、CRP及IL-6可作为脓毒症患者细菌感染的早期诊断标志物。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7c2d/5450606/27b210cc6908/etm-13-06-3479-g00.jpg

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