降钙素原和超敏C反应蛋白定量检测在血流感染患者早期诊断中的应用

Clinical application of detection of procalcitonin and high sensitivity C-reactive protein in the early diagnosis of bloodstream infection

目的探讨血清降钙素原（PCT）、超敏C反应蛋白（hs-CRP）定量检测在血流感染（BSI）早期诊断中的临床价值。方法检测58例BSI患者（试验组）和58例非BSI患者（对照组）血清PCT、hs-CRP水平,利用受试者工作特征（ROC）曲线评价PCT、hs-CRP对BSI的早期诊断价值。结果试验组和对照组血清PCT、hs-CRP水平差异均有统计学意义（P〈0.05）,血清PCT、hs-CRP诊断BSI的ROC AUC分别为0.902（95%置信区间：0.850-0.955）、0.706（95%置信区间：0.611-0.801）,以2.24ng/mL作为最佳截断值时,PCT对BSI的诊断灵敏度、特异度、阳性预测值、阴性预测值分别为77.6%、91.4%、90.0%、80.3%。以64.83mg/L作为最佳截断值时,hs-CRP对BSI的诊断灵敏度、特异度、阳性预测值、阴性预测值分别为74.1%、62.1%、54.4%、59.5%。结论血清PCT、hs-CRP定量检测在BSI早期诊断中具有重要的临床价值。

Objective To investigate the clinical value of detection of procalcitonin（PCT）and high sensitivity C-reactive protein（hs-CRP）in early diagnosis of bloodstream infection（BSI）.Methods The serum levels of PCT and hs-CRP of 58 BSI patients（test group）and 58 non BSI patients（control group）were detected.The early diagnosis value of PCT and hs-CRP was evaluated by ROC curve.Results There were significant difference between the serum PCT and hs-CRP levels of test group and control group（P〈0.05）.The ROC AUC of PCT and hs-CRP were 0.902（95%CI：0.850-0.955）and 0.706（95%CI：0.611-0.801）,respectively.With 2.24ng/mL being the diagnostic cut-off value,the diagnostic sensitivity,specificity,positive predictive value,and negative predictive value of PCT were 77.6%,91.4%,90.0%,and 80.3%,respectively.With 64.83mg/L being the diagnostic cut-off value,the diagnostic sensitivity,specificity,positive predictive value,and negative predictive value of hs-CRP were 74.1%,62.1%,54.4%,and 59.5%,respectively.Conclusion Detection of serum PCT and hs-CRP has important clinical value in early diagnosis of BSI.