降钙素原与中性粒细胞淋巴细胞计数比对心内科住院患者病原菌感染的早期诊断研究

Early diagnosis of pathogen infections in patients with cardiomyopathy by calcitonin and neutrophil lymphocyte count ratio

目的探讨降钙素原与中性粒细胞淋巴细胞计数比对心血管疾病住院患者病原菌感染的早期诊断价值。方法选择2014年1月-2016年10月医院心内科及干部病房住院的652例可能有病原菌感染的老年患者作为研究对象,按照病原菌培养结果分为感染组476例和非感染组176例,分析降钙素原(PCT),白细胞计数(WBC),中性粒细胞计数(NE)和NLR四个指标针对感染的诊断价值。结果 652名患者的病原菌培养结果中,阳性476例占73.01%;阴性176例,占26.99%,感染部位以呼吸道和泌尿系统为主,共分离病原菌476株,其中革兰阳性菌350株占73.53%,革兰阳性菌126株占26.47%,未出现两种以上病原菌的合并感染;感染组WBC,NE,PCT和NLR分别为(14.13±4.32)×109/L,(0.73±0.13)×109/L,(1.25±0.42)ng/ml,(2.59±0.75),显著高于非感染组(10.52±3.95)×109/L,(0.58±0.14)×109/L,(0.40±0.13)ng/ml,(1.42±0.62),PCT的灵敏度和特异度最高,在PCT和NLR两个指标并联使用的情况下,灵敏度进一步增高。结论心血管疾病老年患者感染以呼吸与泌尿系统为主,病原菌分布与常规院内感染分布类似,在PCT和NLR两个指标并联使用的情况下,灵敏度增高,适合对心血管疾病老年患者的病原菌感染进行早期诊断。

OBJECTIVE To investigate the early diagnostic value of calcitonin and neutrophil lymphocyte count in pathogens of hospitalized patients with cardiovascular disease.METHODS All the 652 cases of senile patients who were infected with pathogens were enrolled in the Department of Cardiology and Cadre Ward in the hospital from Jan 2014 to Oct 2016 and were divided into the infection group with 476 cases and the non-infection group with 176 cases according to the results of bacterial culture.The values of procalcitonin（PCT）,white blood cell（WBC）,neutrophil count（NE）and neutrophil lymphocyte count ratio（NLR）in diagnosis of infection were analyzed.RESULTS Among the 652 patients,476cases were positive,accounting for 73.01%,and 176 cases were negative,accounting for 26.99%.The infection sites were mainly respiratory tract and urinary system.Totally 476 strains of pathogens were isolated,of which 350（73.53%）were gram-positive bacteria,126（26.47%）were gram-positive bacteria.The mixed infection caused by more the two species of pathogens emerged.The levels of WBC,NE,PCT,and NLR in the infection group were（14.13±4.32）10^9/L,（0.73±0.13）10^9/L,（1.25±0.42）ng/ml,（2.59±0.75）（10.52±3.95）×10^9/L,（0.58±0.14）×10^9/L,（0.40±0.13）ng/ml,（1.42±0.62）.PCT has the highest sensitivity and specificity.In the PCT and NLR two indicators used in parallel,the sensitivity was further increased.CONCLUSIONIn the elderly patients with cardiovascular disease infection,respiratory and urinary system-based,pathogen distribution and conventional nosocomial infection similar to the PCT and NLR in parallel with the use of two indicators,the sensitivity increased,suitable for elderly patients with cardiovascular disease pathogen infection for early diagnosis.