血清PCT、CRP检测联合血液细菌培养对菌血症的早期诊断价值研究

The early diagnostic value of combined serum PCT,CRP testing and blood bacterial culture in bacteremia

目的探讨血清降钙素原(PCT)、C反应蛋白(CRP)检测联合血液细菌培养(血培养)对菌血症的早期诊断价值。方法将2021年1月至2022年12月广州医科大学附属第四医院收治的285例疑似菌血症患者作为研究对象。患者均进行血清PCT、CRP检测及血培养。根据血培养结果分为菌血症组、非菌血症组,菌血症组又分为革兰阳性菌组、革兰阴性菌组。分析3项指标联合检测对菌血症的诊断价值;同时观察患者病情控制前后血清指标变化。结果菌血症组血清PCT和CRP水平明显高于非菌血症组(P<0.05);革兰阴性菌组患者PCT、CRP水平均明显高于革兰阳性菌组(P<0.05);菌血症患者PCT、CRP联合血培养阳性率为99.35%,高于单项检测,差异有统计学意义(P<0.05)。患者病情控制前后血清PCT、CRP水平比较,差异有统计学意义(P<0.05)。结论血清PCT、CRP检测联合血培养对菌血症的早期诊断具有一定价值,有助于及时调整抗菌药物治疗方案,改善预后。

Objective To investigate the early diagnostic value of combined serum procalcitonin(PCT),C reactive protein(CRP)testing and blood bacterial culture(blood culture)in the diagnosis of bacteremia.Methods A total of 285 patients with suspected bacteremia admitted to the Fourth Affiliated Hospital of Guangzhou Medical University from January 2021 to December 2022 were selected as study subjects.All patients underwent serum PCT,CRP testing and blood culture.According to the blood culture results,patients were divided into bacteremia group and non-bacteremia group.The bacteremia group was further subdivided into Gram-positive bacteria group and Gram-negative bacteria group.The diagnostic value of the combined detection of the three indicators was analyzed,and changes in serum indicators before and after disease control were also observed.Results The serum levels of PCT and CRP in the bacteremia group were significantly higher than those in the non-bacteremia group(P<0.05).The PCT and CRP levels in the Gram-negative bacterial group were significantly higher than those in the Gram-positive bacterial group(P<0.05).The combined positivity rate of PCT,CRP and blood culture in patients with bacteremia was 99.35%,which was higher than that of individual test,with a statistically significant difference(P<0.05).The comparison of serum PCT and CRP levels before and after disease control in patients showed a statistically significant difference(P<0.05).Conclusion The combined detection of serum PCT,CRP and blood bacterial cultures is valuable for the early diagnosis of bacteremia,which helps in timely adjustment of antimicrobial treatment and improving prognosis.