2项指标联合检测对肺部感染患者的诊断价值

Value of combined detection of serum PCT and IL-6 in diagnosis of pulmonary infection

目的探讨血清降钙素原（PCT）与白细胞介素-6（IL-6）联合检测对肺部感染患者的诊断价值。方法收集2013年10月至2014年5月南京市第二医院住院的肺部感染患者,其中细菌性感染32例,非细菌性感染28例;同时随机选取对照组35例的血清标本。采用干式免疫荧光定量法测定各组血清PCT表达水平,电化学荧光定量法测定各组血清IL-6表达水平,并分析其联合检测对肺部感染的诊断价值。结果在细菌性感染组患者血清PCT和IL-6的表达水平均高于非细菌性感染组和对照组,差异有统计学意义（F分别为21.71和39.09,P〈0.05）,而非细菌性感染组和对照组间研究对象血清PCT和IL-6表达水平差异无统计学意义（P〉0.05）,血清PCT诊断细菌性感染的曲线下面积（AUCROC）为0.787（95%CI：0.559-0.999）,血清IL-6为0.934（95%CI：0.829-0.999）,以PCT〉0.5ng/mL、IL-6〉120.0pg/mL为cut off值,PCT与IL-6联合检测时,其诊断的敏感性、特异性、阳性预测值和阴性预测值（分别为87.5%、98.4%、95.6%、94.7%）均高于PCT、IL-6单项检测。结论血清PCT与IL-6联合检测的敏感性和特异性较高,可以用于临床对肺部细菌性感染的辅助诊断。

Objective To explore the clinical value of combination detection of serum procalcitonin（PCT） and interleukin6（IL6） in the diagnosis of pulmonary infection .Methods The patients with pulmonary infection in our hospital from October 2013 to May 2014 were collected ,including 32 cases of bacterial infection and 28 cases of nonbacterial infection ;at the same time and the serum samples in 35 healthy subjects as control group were collected .The expression levels of serum PCT in each group was detected by the dryimmunofluorescence quantitation method ,and the levels of serum IL6 was detected by the electrochemical fluorescence quantitative method .And the diagnostic value of the combined detection of PCT and IL6 in pulmonary infection was analyzed .Results The levels of PCT and IL6 in the bacterial infection group were significantly higher than those in the healthy control group and the nonbacterial infection group （F= 21 .71 ,F= 39 .09 ,P 〈 0 .05） .However ,the nonbacterial infection group and the healthy control group had no statistical difference in serum PCT and IL6 levels（P〉0 .05） .The area under the ROC curves （AUCROC ） of serum PCT for diagnosing bacterial infection was 0 .787 （95% CI ：0 .559 - 0 .999） and which of IL6 was 0 .934（95% CI ：0 .829 - 0 .999） .In PCT 〉0 .5 ng/mL and IL6 〉120 .0 pg/mL as the cut off values respectively , the sensitivity ,specificity ,positive predictive value and negative predictive value of the combined detection of PCT and IL6 in diagnosing pulmonary infection were 87 .5% ,98 .4% ,95 .6% and 94 .7% respectively ,which were significantly higher than those of single PCT or IL6 detection .Conclusion The combination detection of serum PCT and IL6 has higher sensitivity and higher specificity in diagnosing pulmonary infection and can be used in the assisted diagnosis of pulmonary infection .