Zhang Wei, Chen Zhong, Wang Wei-Wei, Lu Wen-Ying, Shang An-Quan, Hu Li-Qing
Department of Laboratorial Medicine, The Fifth People's Hospital of Jiaozuo City, Jiaozuo 454000, Henan Province, China.
Department of Laboratorial Medicine, Luoyang Hospital of Traditional Chinese Medicine, Luoyang 471000, Henan Province, China.
Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2020 Oct;28(5):1746-1749. doi: 10.19746/j.cnki.issn.1009-2137.2020.05.052.
AbstractObjective: To evaluate the diagnostic value of serum PCT, CRP and SAA for bloodstream infection(BSI) in patients with hematopathy.
Sixty hematopathy patients with bloodstream infection from July 2016 to June 2018 were selected and enroued in bloodstream infection group. Sixty-five patients with negative blood culture during the same period were selected and enrolled in non-bloodstream infection group. The ROC curves were drawn and used to eualuate the diagnostic value of above montioned indexes.
The levels of PCT, CRP and SAA in the bloodstream infection group were higher than those in the non-bloodstream infection group (P<0.05). ROC curve showed that AUC values of PCT, CRP, SAA and the combined test detection were 0.868, 0.746, 0.678 and 0.900, respectively, there was no significant difference in AUC between combined test and PCT test (P>0.05). AUC of combined test and PCT test were higher than those of CRP and SAA test, and the difference was statistically significant (P<0.05), but there was no significant difference in AUC between CRP and SAA (P>0.05). The optimal PCT detection threshold was 0.49 ng/ml, the sensitivity and specificity were 75.0% and 83.1%, respectively. The optimal critical value for CRP detection was 15.76 mg/L, the sensitivity and specificity were 60.0% and 80.0% respectively. The optimal SAA detection threshold was 35.66 mg/L, the sensitivity and specificity were 81.7% and 53.8%, respectively.
PCT, CRP and SAA detection have good diagnostic value for blood stream infection in patients with hematopathy. The diagnostic value of PCT is better than CRP and SAA, and there is no significant difference in diagnostic value between combined test and PCT test.
摘要目的：评估血清降钙素原（PCT）、C反应蛋白（CRP）和血清淀粉样蛋白A（SAA）对血液病患者血流感染（BSI）的诊断价值。
选取2016年7月至2018年6月期间60例患有血流感染的血液病患者，纳入血流感染组。选取同期65例血培养阴性的患者，纳入非血流感染组。绘制ROC曲线，用于评估上述指标的诊断价值。
血流感染组的PCT、CRP和SAA水平高于非血流感染组（P<0.05）。ROC曲线显示，PCT、CRP、SAA及联合检测的AUC值分别为0.868、0.746、0.678和0.900，联合检测与PCT检测的AUC无显著差异（P>0.05）。联合检测和PCT检测的AUC高于CRP和SAA检测，差异有统计学意义（P<0.05），但CRP和SAA的AUC无显著差异（P>0.05）。PCT检测的最佳阈值为0.49 ng/ml，灵敏度和特异度分别为75.0%和83.1%。CRP检测的最佳临界值为15.76 mg/L，灵敏度和特异度分别为60.0%和80.0%。SAA检测的最佳阈值为35.66 mg/L，灵敏度和特异度分别为81.7%和53.8%。
PCT、CRP和SAA检测对血液病患者血流感染有良好的诊断价值。PCT的诊断价值优于CRP和SAA，联合检测与PCT检测的诊断价值无显著差异。
