超敏C反应蛋白和细菌计数在浆膜腔细菌感染诊断中的应用

Application of high sensitivity C-reactive protein and bacteria count in the diagnosis of bacterial infection in serous cavity

目的探讨用UF1000i尿沉渣分析仪检测浆膜腔积液细菌计数(BACT)和血清超敏C反应蛋白(hs-CRP)对浆膜腔细菌感染的诊断价值。方法对398例浆膜腔积液标本,用AU2700全自动生化分析仪测定静脉血hs-CRP含量;用UF-1000i全自动尿沉渣分析仪测定BACT;以细菌培养结果为标准对照,评估hs-CRP、BACT诊断浆膜腔细菌感染的灵敏度、特异度、诊断符合率等。结果 398份标本中,细菌培养结果阳性的有49份,阳性率12.3%。以细菌培养为参考方法,hs-CRP诊断浆膜腔细菌感染的灵敏度、特异度、诊断符合率分别为91.8%、56.4%、60.8%;BACT诊断浆膜腔细菌感染的灵敏度、特异度、诊断符合率分别为87.8%、85.4%、85.7%;hs-CRP+BACT诊断浆膜腔细菌感染的灵敏度、特异度、诊断符合率分别为81.6%、95.7%、94.0%;hs-CRP的ROC曲线下面积为0.868,BACT的ROC曲线下面积为0.929。结论 hs-CRP、BACT联检可快速诊断浆膜腔细菌感染并能提高特异度及诊断的符合率。

Objective To explore the diagnosis value of bacteria count（BACT） and serum high sensitivity C-reactive protein（hs-CRP） on bacterial infection in serous cavity by using UF1000i urinary sediment analyzer. Methods AU2700 automatic biochemical analyzer and UF-1000i automatic urine sediment analyzer were used respectively to detect the venous blood hs-CRP content and se-rous cavity BACT in 398 serous cavity effusion samples. Taking the bacterial culture results as the standard control, we evaluated the sensitivity, specificity, diagnose accordance rate etc of hs-CRP and BACT in the diagnosis of bacterial infection in serous cavity. Results In 398 samples,49 samples were positive in bacterial culture results and the positive rate was 12.3%. Taking bacterial cul-ture as the reference method, the sensitivity, specificity and diagnostic accordance rate were 91.8 %, 56.4 % and 60.8 % when using hs-CRP method,87.8% ,85.4% ,85.7% when using BACT method,and 81.6% ,95.7% ,94.0% when using joint detection of hs-CRP and BACT to diagnose the bacterial infection in serous cavity. The area under the ROC curve of hs-CRP and BACT was 0. 868 and 0. 929,respectively. Conclusion Joint detection of Hs-CRP and BACT is a rapid way to diagnose the bacterial infection in se-rous cavity. The specificity and diagnose accordance rate is higher compared to the bacterial culture method.