血清降钙素原及血沉与C-反应蛋白联合检测诊断化脓性关节炎临床价值

Diagnosis value of joint detection of serum procalcitonin,erythrocyte sedimentation rate,C-reactive protein for suppurative arthritis

目的探讨血清降钙素原(PCT)、血沉(ESR)、C-反应蛋白(CRP)联合检测诊断化脓性关节炎后感染临床价值,为临床诊断提供参考。方法选择2012年1月-2014年12月51例急性关节炎患者,根据病原学检测结果,将化脓性关节炎患者14例为观察A组,非化脓性关节炎患者37例为观察B组,另取同期48名健康者为对照组,对比3组受试者PCT、ESR及CRP水平以及不同诊断指标的灵敏度及特异性。结果观察A组PCT、ESR及CRP指标分别为(7.34±1.15)μg/L、(35.64±4.98)mm/h及(16.88±2.34)mg/L,明显高于观察B组及对照组,同时观察B组高于对照组,组间对比差异有统计学意义(P<0.05);观察A组PCT、ESR、CRP阳性率分别为92.86%、85.71%、92.86%,明显高于观察B组,对比差异有统计学意义(P<0.05);PCT+ESR+CRP联合检测灵敏度为100.00%,相比单独检测明显升高,差异有统计学意义(P<0.05),特异性为75.68%,与特异性最高的PCT(72.97%)对比差异无统计学意义。结论 PCT相比ESR、CRP检测诊断化脓性关节炎敏感度更高,3者联合检测利于提升诊断灵敏度及特异性,有助于提升诊断准确率。

OBJECTIVE To investigate diagnosis value of joint detection of serum procalcitonin ,erythrocyte sedi‐mentation rate ,C‐reactive protein for suppurative arthritis ,so as to provide a reference for clinical treatment . METHODS Totally 51 patients with acute arthritis from Jan .2012 to Dec .2014 were selected .According to the results of pathogenic detection ,14 patients with suppurative arthritis were set as the observation group A ,37 pa‐tients with non suppurative arthritis were set as was the observation group B ,and the other 48 cases of healthy people over the same period were taken as the control group .Sensitivity of serum procalcitonin in the three groups ,erythrocyte sedimentation rate ,C‐reactive protein levels and different diagnostic indicators and specificity were compared .RESULTS In the observation group A ,PCT ,ESR and CRP indexes were （7 .34 ± 1 .15） g/L , （35 .64 ± 4 .98） mm/h ,（16 .88 ± 2 .34） mg/L ,significantly higher than the observation group B and the control group ,and these indexes in the observation group B were significantly higher than in the control group（P〈0 .05） . In the observation group A ,ESR;PCT ,CRP positive rates were 92 .86% ,85 .71% ,92 .86% ,significantly high‐er than those in the observation group B （P〈 0 .05） .Sensitivity of PCT ＋ ESR ＋ CRP joint detection was 100 .00% ,increased significantly compared to a separate detection （P〈0 .05） .The specificity was 75 .68% ,no significant difference showed compared with the highest specificity of PCT （72 .97% ） .CONCLUSION Compared with erythrocyte sedimentation rate and C‐reaction protein detection ,serum procalcitonin in the diagnosis of sup‐purative arthritis is more sensitive .Joint detection has the benefit to improve the diagnostic sensitivity and specific‐ity ,which helps to improve the accuracy rate of diagnosis .