人急性布鲁杆菌病降钙素原与C-反应蛋白含量研究及其临床意义

Investigation on contents and clinical value of procalcitonin and C-reactive protein in patients with acute brucellosis

目的探讨降钙素原(PCT)与C-反应蛋白(CRP)测定在急性布鲁杆菌病(布病)患者中的应用价值。方法对黑龙江省农垦总局总医院127例急性布病患者、102例慢性布病患者和60例健康检查者进行PCT及CRP含量检测;并比对治疗前后PCT和CRP测定值。结果 127例急性布病患者中,PCT测定值为(2.42±0.61)ng/ml,阳性率为67.72%;CRP测定值为(33.3±7.9)mg/L,阳性率为59.06%。102例慢性布病患者PCT及CRP测定值分别为(0.16±0.04)ng/ml和(5.2±0.7)mg/L,阳性率分别为7.84%和11.76%;60例健康对照组PCT及CRP测定值分别为(0.11±0.02)ng/ml和(3.2±1.1)mg/L。急性布病组与慢性布病组、健康对照组比较,差异均有统计学意义(均P<0.01)。单项检测时,PCT灵敏度、特异度、阳性预测值和阴性预测值均高于CRP。二者联合检测时灵敏度和阴性预测值最高。急性布病患者治疗后PCT、CRP测定值低于治疗前,两者比较差异均有统计学意义(P<0.05)。结论联合检测PCT和CRP可提高早期诊断急性布鲁杆菌感染的灵敏度,可用于抗感染治疗的动态监测,对转归的预测具有临床价值。

[Objective]To investigate the application value of procalcitonin（PCT） and C-reactive protein（CRP） in acute brucellosis patients.[Methods]127 patients with acute brucellosis,102 patients with chronic brucellosis and 60 healthy controls were recruited in the study. The levels of PCT and CRP were detected,and the results before and after therapy were compared.[Results]Among127 acute brucellosis patients,the level of PCT was（2.42±0.61）ng/ml with the positive rate of 67.72%,and the level of CRP was（33.3±7.9） mg/L with the positive rate of 59.06%. The level of PCT and CRP in 102 chronic brucellosis patients was（0.16±0.04） ng/ml and（5.2±0.7） mg/L respectively,and the positive rate was 7.84% and 11.76% respectively.The level of PCT and CRP in 60 healthy controls was（0.11 ±0.02） ng/mland（3.2 ±1.1） mg/L respectively. The differences were statistically significant between acute brucellosis group and chronic brucellosis group,acute brucellosis group and healthy control group（P〈0.01）. In the single detection,the sensitivity,specificity,positive predictive value and negative predictive value of PCT were higher than those of CRP. The combined detection of PCT and CRP showed the highest sensitivity and negative predictive value. In the acute brucellosis group,the levels of PCT and CRP after the therapy were lower than those before therapy,and the differences were statistically significant（P〈0.05）.[Conclusion]The combined detection of PCT and CRP can improve the sensitivity of early diagnosis in acute brucellosis,it can be used to monitor dynamically on the therapy of antiinfection,and shows the clinical value on the prediction of the prognosis.