降钙素原与超敏C-反应蛋白在感染性和非感染性疾病中的应用价值评价

Evaluation on the applied value of procalcitonin and hypersensitive C-reactive protein in infectious and non-infectious diseases

目的探讨联合检测降钙素原(PCT)和超敏C-反应蛋白(hs-CRP)在鉴别诊断感染性和非感染性疾病及炎症感染严重程度中的应用价值,为临床提供可靠的诊断依据。方法收集182例样本,其中一般感染性疾病患者109例(包括细菌感染68例,病毒感染41例);非感染性疾病患者48例(包括不明原因发热17例,过敏反应31例),全身性重度感染者25例[脓毒症及脓毒性休克17例、多器官功能衰竭综合征(MODS)8例],并分别行血清PCT和全血hs-CRP检测。结果一般感染与非感染性患者的PCT和hs-CRP比较差异均具有统计学意义(χ2PCT=75.46,P<0.01;χ2hs-CRP=91.31,P<0.01),全身重度感染与一般感染者的PCT和hs-CRP水平比较差异亦具有统计学意义(χ2PCT=68.73,P<0.01;χ2hs-CRP=57.67,P<0.01)。一般感染与全身性重度感染者的PCT和hs-CRP水平比较差异具有统计学意义(χ2PCT=7.05,P<0.01;χ2hs-CRP=4.77,P<0.05)。结论 PCT和hs-CRP联合检测可鉴别诊断感染性和非感染性疾病及炎症感染严重程度;用hs-CRP筛查,对可疑者应做PCT检测,二者联合检测可作为判断病情与预后以及疗效观察的可靠指标。

Objective To provide reliable clinical diagnostic basis, and evaluate the applied value of procalcitionin （PCT） and hypersensitive C-reactive protein （hs-CRP） in identifying and diagnosing infectious and noninfectious diseases and the severity of inlfammatory infection. Methods Total of 182 specimens were collected, including 109 cases with general infectious diseases （68 cases with bacterial infection and 41 cases with virus infection）;48 cases with non-infectious diseases （17 cases with fever of unknown origin and 31 cases with anaphylaxis）;25 cases with systemic severe infection [17 cases of sepsis and septic shock and 8 cases of multiple organ failure syndrome （MODS）]. The levels of serum PCT and blood hs-CRP were detected, respectively. Results Both PCT and hs-CRP in patients of ordinary infection had significant difference compared with non-infection patients （χ2PCT=75.46, P〈0.01;χ2hs-CRP=91.31, P〈0.01）, and the difference was signiifcant when systemic severe infections and ordinary infection patients compared （χ2PCT=68.73,P〈0.01;χ2hs-CRP=57.67,P〈0.01）. The levels of PCT and hs-CRP for ordinary infectious and patients with systemic severe infections were compared with signiifcant differences （χ2PCT=7.05,P〈0.01;χ2hs-CRP=4.77,P〈0.05）. Conclusions When PCT and hs-CRP were detected together, it would identify and diagnose infectious and non-infectious diseases and the severity of inlfammatory infection. Screening with hs-CRP, then testing with PCT when suspicion occurs, with all the detecting together, the result should be a reliable indicator to judgement the prognosis and observation of curative effect of the disease.