C-反应蛋白联合血清降钙素原检测在脓血症和菌血症中的应用

Clinical value of serum procalcitonin and C-reactive protein on diagnosis of SEPSIS and Bacteremia

目的 探讨C-反应蛋白（CRP）联合血清降钙素原（PCT）检测在脓血症和菌血症中的应用价值.方法 选择细菌感染患者368例作为研究对象,根据ACCP/SCCM诊断标准将所有患者分为菌血症组217例和脓毒血症组151例,另选择50例健康者作为对照组,比较所有研究对象治疗前和治疗后1、3、5d测定的CRP、PCT和白细胞（WBC）水平.结果 治疗前,脓毒血症组患者和菌血症组患者的CRP、WBC以及PCT比较差异有统计学意义;治疗5d后,所有患者的PCT水平普遍明显下降,CRP水平仍然维持在较高的水平,处于病理状态,而WBC在治疗过程中呈现出不规则波动状态.结论 CRP联合PCT检测可以作为脓血症和菌血症早期诊断的依据,具有一定的诊断价值,能够指导临床治疗.

Objective To evaluate clinical value of serum procalcitonin （PCT） and C-reactive protein（CRP） on diagnosis of SEPSIS and bacteremia.Methods Three hundred and sixty-eight patients with bacterial infections were divided into SEPSIS group（151 cases） and bacteremia group（217 cases） on the basis of ACCP/SCCM,and another 50 cases of healthy subjects were seected as the control group,the three groups of serum PCT,CRP and WBC were determined and analyzed.Results Before the treatment,CRP,WBC and PCT of patients with sepsis and bacteremia were significantly different,after treatment of 5 d,all patients＆#39; PCT declined obviously,CRP still maintained at a high level,and WBC irregular fluctuated in the pathological state.Conclusions PCT for serious sepsis and bacteremia sensitive diagnosis is higher than that of the CRP,monitoring serum PCT and CRP levels can be used as a specific indicator of serious bacterial infection,which has guiding significance for clinical diagnosis and treatment.