细菌感染与血清炎症指标间关系及其诊断价值

The relationship between bacterial infection and serum inflammatory markers and the value of combined diagnosis for disease

目的研究细菌感染与血清炎症指标间关系并分析其诊断价值。方法选择2021年1月-2022年2月枞阳县人民医院收治的细菌感染患者80例作为细菌感染组,以及同期住院的非细菌感染患者60例作为对照组,细菌感染组根据感染严重程度分为菌血症组(n=35)、脓毒血症组(n=27)和严重脓毒血症组(n=18);根据感染类型分为革兰阳性菌(G^(+))感染组(n=38)和革兰阴性菌(G^(-))感染组(n=42);观察各组受试对象血清白细胞介素-6(IL-6)、血清C反应蛋白(CRP)、降钙素原(PCT)含量,比较分析细菌感染患者感染严重程度和感染类型对血清炎症指标影响,分析血清炎症指标与细菌感染的关系及其对细菌感染的诊断价值。结果细菌感染组血清IL-6、PCT、CRP含量分别为(357.41±55.29)ng/mL、(5.98±1.61)ng/mL、(85.91±15.33)mg/mL,明显高于对照组的(6.82±2.11)ng/mL、(0.22±0.15)ng/mL、(1.52±0.54)mg/mL,差异均有统计学意义(P均<0.05)。菌血症组、脓毒血症组、严重脓毒血症组血清IL-6、PCT、CRP含量均显著高于对照组,差异均有统计学意义(P均<0.05);严重脓毒血症组血清IL-6含量低于菌血症组、脓毒血症组,差异均有统计学意义(P均<0.05);血清PCT、CRP含量按对照组、菌血症组、脓毒血症组、严重脓毒血症组依次递增,组间比较差异均有统计学意义(P均<0.05)。血清IL-6、PCT、CRP含量按对照组、G^(+)感染组、G^(-)感染组依次递增,组间比较差异均有统计学意义(P均<0.05)。Spearman相关性分析结果显示,细菌感染、感染严重程度及感染类型均与血清IL-6、PCT、CRP含量成正相关(P<0.05)。受试者工作特征(ROC)曲线结果显示,IL-6、PCT、CRP对细菌感染诊断的曲线下面积(AUC)分别为0.874、0.945、0.919,IL-6、PCT、CRP联合诊断的AUC为0.959,高于血清IL-6、CRP单一诊断,差异有统计学意义(P<0.05)。结论血液细菌感染与血清炎症指标间关系密切,通过对炎症标志物联合检查能提高疾病早期辅助诊断价值。

Objective To study the relationship between bacterial infection and serum inflammatory markers and analyze their diagnostic value.Methods Retrospectively,80 patients with bacterial infection who were admitted to the Zongyang County People’s Hospital from January 2021 to February 2022 were selected as the bacterial infection group,and 60 patients with non-bacterial infection who were hospitalized during the same period were selected as the control group.The bacterial infection group was divided into bacteremia group(n=35),sepsis group(n=27),severe sepsis group(n=18)based on the severity of the infection,according to the type of infection into gram positive bacteria(G^(+))infection(n=38),gram negative bacteria(G^(-))infection group(n=42).The serum levels of interleukin-6(IL-6),serum C-reactive protein(CRP),and procalcitonin(PCT)in the two groups of subjects were observed,and the effects of infection severity and infection type on serum inflammatory indexes in patients with bacterial infection were compared and analyzed.The relationship between serum inflammatory markers and bacterial infection and their diagnostic value for bacterial infection was analyzed.Results The serum levels of IL-6,PCT and CRP in the bacterial infection group[(357.41±55.29)ng/mL,(5.98±1.61)ng/mL,(85.91±15.33)mg/mL]were significantly higher than those in the control group[(6.82±2.11)ng/mL,(0.22±0.15)ng/mL,(1.52±0.54)mg/mL](P all<0.05).The serum levels of IL-6,PCT and CRP in the bacteremia group,sepsis group and severe sepsis group were significantly higher than those in the control group(P all<0.05),and the serum IL-6 level in the severe sepsis group was lower than in the bacteremia group and the sepsis group(P all<0.05);the serum PCT and CRP levels increased in the control group,the bacteremia group,the sepsis group and the severe sepsis group,the difference between groups were statistically significant(P all<0.05).The levels of serum IL-6,PCT,and CRP increased in the control group,G^(+)infection group and G^(-)infection group,and the differences between groups were statistically significant(P all<0.05).The results of Spearman correlation analysis showed that bacterial infection,infection severity and infection type were positively correlated with serum IL-6,PCT and CRP levels(P<0.05).The receiver operating characteristic(ROC)curve results showed that the area under the curve(AUC)of IL-6,PCT and CRP for the diagnosis of bacterial infection were 0.874,0.945 and 0.919,respectively,and the AUC for the combined diagnosis of IL-6,PCT and CRP was 0.959,higher than the single diagnosis of serum IL-6 and CRP,the difference was statistically significant(P<0.05).Conclusion There was a close relationship between blood bacterial infection and serum inflammatory markers,and the combined inspection of inflammatory markers could improve the early auxiliary diagnosis value of the disease.