降钙素原（PCT）、超敏C反应蛋白（hs-CRP）及血清淀粉样蛋白A（SAA）检测在脓毒症早期诊断中的临床应用价值比较
Comparison of the clinical application values of PCT, hs-CRP and SAA detection in the early diagnosis of sepsis.
作者信息
Sui Yuan-da, Xin Wei-Na, Feng Lin-Lin
机构信息
Yuan-da Sui, Department of Critical Medicine, Liaocheng People's Hospital, 252000, Liaocheng, Shandong, P. R. China.
Wei-na Xin, Department of Respiratory Medicine, Liaocheng People's Hospital, 252000, Liaocheng, Shandong, P. R. China.
出版信息
Pak J Med Sci. 2020 Nov-Dec;36(7):1683-1687. doi: 10.12669/pjms.36.7.2544.
OBJECTIVES
To investigate the clinical application values of procalcitonin (PCT), high-sensitivity C-reactive protein (hs-CRP) and serum amyloid A (SAA) in the early diagnosis of sepsis.
METHODS
In this retrospective analysis, 36 patients admitted to Liaocheng People's Hospital were selected from May 2018 to July 2019. According to infectious disease diagnostic criteria, 17 patients were confirmed to have sepsis (observation group), and 19 patients were determined to be nonseptic (control group). The levels of PCT, CRP and SAA of patients were detected on admission, and the clinical application values of PCT, CRP and SAA for sepsis were compared.
RESULTS
Seventeen patients were included in the observation group, including 9 males and 8 females, with an average age of 52.18 ± 9.49 years; 19 patients were included in the control group, including 12 males and 7 females, with an average age of 51.53 ± 8.50 years. On admission, there were significant differences in white blood cell (WBC) count ( = 5.134), neutrophil count ( = 3.143), lymphocyte count ( = 2.510), PCT ( = 9.250), hs-CRP ( = 2.947) and SAA ( = 11.360) between the observation group and the control group, and the differences were statistically significant. For the comparison of clinical application values: the sensitivity of PCT, hs-CRP and SAA was 78.95%, 52.17% and 50.00%, respectively; the specificity of PCT, hs-CRP and SAA was 88.24%, 61.54% and 37.50%, respectively; the area under the ROC curve (AUC) of PCT, hs-CRP and SAA was 0.920, 0.684 and 0.870, respectively; the logistic regression coefficient of PCT, hs-CRP and SAA was -0.577, -0.028 and -0.009, respectively; and the 95% confidence interval (CI) of PCT, hs-CRP and SAA was 0.779-0.985, 0.508-0.828 and 0.716-0.958, respectively.
CONCLUSION
Compared with hs-CRP and SAA, PCT had a higher clinical application value for sepsis, and PCT could be used as a reliable index for the early diagnosis of sepsis.
目的
探讨降钙素原（PCT）、高敏C反应蛋白（hs-CRP）及血清淀粉样蛋白A（SAA）在脓毒症早期诊断中的临床应用价值。
方法
本回顾性分析选取2018年5月至2019年7月在聊城市人民医院住院的36例患者。根据传染病诊断标准，确诊脓毒症患者17例（观察组），非脓毒症患者19例（对照组）。入院时检测患者的PCT、CRP及SAA水平，比较PCT、CRP及SAA对脓毒症的临床应用价值。
结果
观察组纳入17例患者，其中男性9例，女性8例，平均年龄（52.18±9.49）岁；对照组纳入19例患者，其中男性12例，女性7例，平均年龄（51.53±8.50）岁。入院时，观察组与对照组白细胞计数（=5.134）、中性粒细胞计数（=3.143）、淋巴细胞计数（=2.510）、PCT（=9.250）、hs-CRP（=2.947）及SAA（=11.360）比较，差异均有统计学意义。临床应用价值比较：PCT、hs-CRP及SAA的敏感度分别为78.95%、52.17%及50.00%；特异度分别为88.24%、61.54%及37.50%；ROC曲线下面积（AUC）分别为0.920、0.684及0.870；Logistic回归系数分别为-0.577、-0.028及-0.009；95%置信区间（CI）分别为0.779～0.985、0.508～0.828及0.716～0.958。
结论
与hs-CRP及SAA相比，PCT对脓毒症具有更高的临床应用价值，可作为脓毒症早期诊断的可靠指标。
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