降钙素原与C-反应蛋白在发热患者病因学鉴别诊断中的价值

Differential Diagnosis value of Procalcitonin and C-reactive protein in fever patients

目的探讨降钙素原(PCT)与C-反应蛋白(CRP)在发热患者病因学早期诊断中的应用价值。方法选取本院收治的52例体温大于38℃的患者为研究对象,检测血清中PCT与CRP的含量并根据临床资料和统计学分析评价其与临床病因学之间的关系。结果所有患者当中,PCT和CRP均无法区别感染性发热和非感染性发热,两者接受者工作特征曲线下面积分别为0.62(95%CI为0.45～0.78,P=0.14)和0.61(95%CI为0.43～0.79,P=0.22)。当PCT临界值分别为0.2μg/L和10.0μg/L时,其敏感性和特异性分别为59%和67%、3%和100%。此外,PCT和CRP能区分细菌性发热和病毒性发热(P<0.05)。结论仅根据PCT和CRP无法鉴别患者是否为感染性发热,但能区分病毒性性发热与细菌染性感染。

Objective To explore the application value of Procalcitonin （PCT） and C-reactive protein （CRP） in early diagnosis of etiology of fever patients. Methods 52 patients whose temperatures were over 38~C in our hospital were selected and the level of PCT and CRP in serum were detected,then the relations of PCT,CRP and the etiology was analyzed according to the clinical data and statistical analysis. Results For all the patients,neither PCT nor CRP could distinguish the infection and non-infection （P〉 0.05） ,with an area under the receiver operating characteristic curve of 0.62 （95% CI 0.45-0. 78,P=0.14） for PCT and 0. 61 （95% CI 0. 43-0. 79,P=0. 22） for CRP. Sensitivity and specificity for PCT was 59%and 67% for a cut-off point of 0.2 μg/L,and 3% and 100% for a cut-off point of 10.0 μg/L. However,PCT was able to discriminate between bacterial infection and viral infec- tion （P〈0.05）. Conclusion PCT and CRP can not distinguish the infection and non-infection,but can discriminate between bacte- rial infection and viral infection.