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[降钙素原、C反应蛋白及白细胞介素-6在血液病合并细菌感染中的诊断价值]

[Diagnostic Values of Procalcitonin, C-reactive Protein and Interleukin-6 in Hematological Diseases with Bacterial Infection].

作者信息

Liu Tong-Bo, Wang Mao-Quan, Guan Wei, Jing Yu

机构信息

Department of Computer, General Hospital of Chinese PLA, Beijing 100853, China.

Department of Hematology, General Hospital of Chinese PLA, Beijing 100853, China.

出版信息

Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2018 Oct;26(5):1548-1552. doi: 10.7534/j.issn.1009-2137.2018.05.048.

Abstract

OBJECTIVE

To evaluate the diagnostic values of procalcitonin(PCT), C-reactive protein(CRP) and interleukin-6 (IL-6) in patients suffered from hematological diseases with bacterial infection, and to provide further evidence for clinical application.

METHODS

A total of 3631 blood cultures, serum levels of PCT and CRP and IL-6 (n=1587) from the inpatients from 2014-01-02 to 2018-01-27 were retrospectively analyzed. The patients were divided into positive (n=208) and negative blood culture (n=3423) groups. Positive blood culture group were redivided into gram-positive (n=34) and gram-negative (n=174) subgroups. The values CRP, PCT and IL-6 were compared respectively in these groups. The data were analyzed by using R 3.4.4 language.

RESULTS

The medians of PCT values in positive and negative blood culture groups were 0.41(0.04-103.34) μg/L and 0.20(0.02-200) μg/L(P<0.001) respectively. The medians of CRP values in positive and negative blood culture groups were 9.49(0.1-370) mg/dl and 5.42(0-370) mg/dl (P<0.001) respectively. The medians of IL-6 values in positive and negative blood culture groups were 186.1(2.0-5000, n=91) pg/ml and 52.65(1.5-5000, n=1496) pg/ml (P<0.001). The medians of PCT values in gram-positive and gram-negative groups were 0.20(0.05-93.83) μg/L and 0.58(0.04-103.34) μg/L (P=0.006) respectively. The medians of CRP value in gram-positive and gram-negative groups were 9.19(0.1-35.3)mg/dL and 9.49(0.1-370) mg/dl (P=0.300) respectively. The medians of IL-6 values in gram-positive and gram-negative groups were 83.01(5.61-1500, n=12) pg/ml and 208(2.0-5000, n=79) pg/ml (P=0.357).

CONCLUSION

The PCT, CRP and IL-6 levels were significantly higher in the positive blood culture group than those in the negative blood culture group, so provide the effective early diagnostic markers for blood culture. PCT levels in gram-positive group were significantly higher than that in gram-negative groups, contributing to distinguish between the 2 groups.

摘要

目的

评估降钙素原(PCT)、C反应蛋白(CRP)及白细胞介素-6(IL-6)对血液病合并细菌感染患者的诊断价值,为临床应用提供依据。

方法

回顾性分析2014年1月2日至2018年1月27日住院患者的3631份血培养、血清PCT、CRP及IL-6水平(n = 1587)。患者分为血培养阳性组(n = 208)和血培养阴性组(n = 3423)。血培养阳性组再分为革兰阳性菌组(n = 34)和革兰阴性菌组(n = 174)。比较各组CRP、PCT及IL-6水平。采用R 3.4.4语言进行数据分析。

结果

血培养阳性组和阴性组PCT水平中位数分别为0.41(0.04 - 103.34)μg/L和0.20(0.02 - 200)μg/L(P < 0.001)。血培养阳性组和阴性组CRP水平中位数分别为9.49(0.1 - 370)mg/dl和5.42(0 - 370)mg/dl(P < 0.001)。血培养阳性组和阴性组IL-6水平中位数分别为186.1(2.0 - 5000,n = 91)pg/ml和52.65(1.5 - 5000,n = 1496)pg/ml(P < 0.001)。革兰阳性菌组和革兰阴性菌组PCT水平中位数分别为0.20(0.05 - 93.83)μg/L和0.58(0.04 - 103.34)μg/L(P = 0.006)。革兰阳性菌组和革兰阴性菌组CRP水平中位数分别为9.19(0.1 - 35.3)mg/dL和9.49(0.1 - 370)mg/dl(P = 0.300)。革兰阳性菌组和革兰阴性菌组IL-6水平中位数分别为83.01(5.61 - 1500,n = 12)pg/ml和208(2.0 - 5000,n = 79)pg/ml(P = 0.357)。

结论

血培养阳性组PCT、CRP及IL-6水平显著高于血培养阴性组,可作为血培养有效的早期诊断指标。革兰阳性菌组PCT水平显著高于革兰阴性菌组,有助于两者的鉴别。

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