摘要
目的评估CRP、PCT及两者联合检测对于肺炎致脓毒症的诊断价值。方法选取我院诊断为肺炎的患者100例作为研究对象。经Sepsis-3标准,将其分为脓毒症组和非脓毒症组。ROC曲线、优势比(OR)分析两个指标及联合检测的诊断价值。结果 CRP诊断肺炎致脓毒症的ROC曲线下面积为0.813,最佳阂值为50 mg/L,此阂值时诊断的敏感性为90%,特异性69%,阳性预测值80%,阴性预测值83%;PCT的ROC曲线下面积0.772,最佳阂值为0.91 ng/ml,此阂值时诊断的敏感性83%,特异性68%,阳性预测值79%,阴性预测值74%。采用上述阈值联合检验时,敏感性为79%,特异性为84%,阳性预测值89%,阴性预测值71%;联合检验的OR值为19,CRP的OR值为18,PCT的OR值为9。结论 CRP具有较高的阴性预测价值,更适宜用于肺炎致脓毒症患者的排除诊断。PCT的诊断价值不优于CRP,采用PCT与CRP双阳性结果联合评估,对诊断具有更好的特异性及阳性预测价值。
Objective To assess the diagnostic value of combined detection of CRP, PCT and both of them for sepsis caused by pneumonia. Methods 100 cases of pneumonia diagnosed in our hospital were selected as the subjects. By Sepsis-3 standard, they were divided into sepsis group and non sepsis group, the diagnostic value of two indicators and joint detection were analysed by ROC curves and odds ratio （OR）. Results The area under ROC curve of pneumonia diagnosed by CRP was 0.813, the best threshold value was 50 rag/L, the threshold sensitivity of diagnosis was 90%, the specificity was 69%, the positive predictive value was 80%, and the negative predictive value was 83%. The area under the PCT curve of ROC was 0.772, the optimal threshold was 0.91 ng/ml, the threshold sensitivity of diagnosis was 83%, the specificity was 68%, positive predictive value was 79%, and negative predictive value was 74%. When using the above threshold combination test, the sensitivity was 79%, the specificity was 84%, the positive predictive value was 89%, and the negative predictive value was 71%. The OR value of the joint test was 19, the OR value of CRP was 18, and the OR value of PCT was 9. Conclusion CRP has high negative predictive value, the utility model is more suitable for the exclusion diagnosis of sepsis caused by pneumonia. The diagnostic value of PCT is not superior to that of CRP, double positive results assessed by PCT and CRP have better specificity and positive predictive value for diagnosis.
出处
《中国继续医学教育》
2017年第15期63-65,共3页
China Continuing Medical Education
