降钙素原和C反应蛋白在细菌和真菌感染中的辅助诊断价值

The auxiliary diagnostic value of procalcitonin and C-reactive protein in bacterial and fungal infection

目的 :通过分析降钙素原(procalcitonin,PCT)和C反应蛋白(C-reactive protein,CRP)在细菌和(或)真菌感染患者中的变化,探讨这2项指标的诊断价值。方法:以284例患者的一般细菌和真菌培养结果作为金标准,同时采用上转化学发光法检测其血浆PCT,并用免疫比浊法检测其血浆CRP水平。结果:细菌和(或)真菌培养结果为阳性者与阴性者相比,其血浆PCT和CRP水平均明显增高(P<0.001)。当PCT临界值为0.31 mg/L时,其诊断细菌和(或)真菌感染的灵敏度和特异度分别为68.1%和57.1%;当CRP临界值为11.1 mg/L时,其诊断灵敏度和特异度则分别为73.0%和46.4%。2个指标结果差异无统计学意义(P>0.05)。结论:血浆PCT水平可作为细菌和(或)真菌感染的筛检指标之一,其诊断性能与CRP类似。

Objectives To investigate the changes of procalcitonin （PCT） and C-reactive protein （CRP） in patients with bacterial or fungal infection,so as to evaluate their diagnostic value. Methods The results of bacterial and fungal cultures of 284 patients were used as the gold standard, while PCT was detected by chemiluminescence assay and CRP by immune turbidimetry. Results Levels of PCT and CRP were significantly higher in patients with positive bacterial and fungal culture when compared with those with negative bacterial and fungal culture （P〈0.001）. When 0.31 mg/L was taken as the cut off value for PCT, its diagnostic sensitivity and specificity for bacterial and fungal infection were 68.1% and 57.1%, respectively. When l l.lmg/L was taken as the cut off value for CRP, its diagnostic sensitivity and specificity were 73.0% and 46.4%, respectively. However, there was no significant difference between CRP and PCT in diagnostic performance （P〉0.05）. Conclusions PCT could be used as one of the screening tests for bacterial or fungal infection, and its diagnostic performance is similar to that of CRP.