PCT和CRP对菌血症的诊断价值比较

The value of PCT and CRP to diagnosis of bacteremia

目的检测降钙素原(PCT)和C反应蛋白(CRP)水平,探讨两者预测患者菌血症的可行性,为辅助临床诊断菌血症提供简单、快捷的检测方法。方法 129例疑似为菌血症的住院患者为研究组,同期健康体检者20例为对照组。采集血液标本后进行血培养,免疫层析法检测PCT,速率散射比浊法测定CRP。结果研究组患者PCT、CRP水平均明显高于对照组,差异有统计学意义(P<0.05)。129例研究组患者中,血培养阳性41例,阳性率31.78%;PCT阳性83例,阳性率64.34%;CRP阳性104例,阳性率80.62%。PCT检测的敏感性和特异性分别为89.04%和67.86%,CRP检测的敏感性和特异性分别为94.87%和56.22%。对PCT和CRP做受试者工作特征曲线(ROC曲线),结果显示PCT对菌血症的诊断效果较好,曲线下面积为0.846;CRP的曲线下面积为0.71。结论 PCT是早期菌血症较好的辅助诊断指标,其诊断性能明显优于CRP。

Objective To detect procalcitonin （PCT） and C reactive protein （CRP） ,to explore the feasibility of bacteremia in pa- tients,and to provide a simpler and quicker detective method for the diagnosis of bacteremia. Methods We studied 129 in-patients enrolled between May 2013 and June 2013 in hospital who were suspected of bacteremia and also 20 healthy people as a control group. The blood samples were collected to carry out blood culture,detection of PCT by immune chromatography and CRP by rate nephelometry. Results The levels of PCT,CRP in research groups were significantly higher than those in control group,the differ- ence was statistically significant （P〈0.05）. 129 cases of research group patients,blood culture was positive in 41 cases,the positive rate was 31.78%; PCT was positive in 83 cases,the positive rate was 64.34%; CRP was positive in 104 cases,the positive rate was 80.62%. The sensitivity and specificity of PCT were 89.04% and 67.86% ,the same as CRP were 94.87% and 56.22%. The results by receiver operating characteristic curves （ROC curve） of PCT and CRP showed that PCT was a better diagnostic effect of bacteraemia,the area of curve was 0. 846. However the area of CRP was 0.71. Conclusion PCT is an early and better auxiliary di agnosis index in diagnosing bacteremia,its diagnostic performance is better than the CRP..