痰培养联合血清PCT、CRP、ESR水平检测对下呼吸道感染的诊断价值

Value of sputum culture combined with serum PCT,CRP and ESR levels in the diagnosis of lower respiratory tract infection

目的 探讨痰培养联合血清血沉（ESR）、C-反应蛋白（CRP）、降钙素原（PCT）水平检测对下呼吸道感染患者的诊断价值.方法 选取医院下呼吸道感染患者59例做为研究组,其中细菌性感染27例,非细菌性感染32例,另选同期健康体检者58例设为对照组,均取痰标本进行痰培养,均行血清ESR、CRP、PCT水平检测.比较两组血清ESR、CRP、PCT表达水平,对比细菌性感染与非细菌性感染患者血清ESR、CRP、PCT表达水平,统计研究组致病菌分布情况,统计痰培养,血清ESR、CRP、PCT水平检测及临床证实下呼吸道感染结果 ,以临床证实结果作为＂金标准＂,比较痰培养、血清ESR、CRP、PCT水平单一检测及联合检测下呼吸道感染结果.结果 研究组血清ESR、CRP、PCT表达水平高于对照组,差异有统计学意义（P〈0.05）;细菌性感染患者血清ESR、CRP、PCT表达水平高于非细菌性感染患者,差异有统计学意义（P〈0.05）;研究组致病菌共178株,其中真菌4株,占2.25％;革兰阴性菌81株,占45.51％,革兰阳性菌93株,占52.24％;痰培养、血清ESR、CRP、PCT水平联合检测下呼吸道感染敏感性、特异性、准确性均高于单一检测,差异有统计学意义（P〈0.05）.结论 下呼吸道感染患者血清ESR、CRP、PCT水平高表达,血清ESR、CRP、PCT检测有助于鉴别感染类型,痰培养与血清ESR、CRP、PCT水平联合诊断下呼吸道感染,可明显提高诊断的敏感性、特异性、准确性,应用价值较高.

Objective To investigate the application value of sputum culture combined with ser-um erythrocyte sedimentation rate （ESR）,C-reactive protein （CRP）and procalcitonin （PCT）levels in the diagnosis of lower respiratory tract infection. Methods Fifty-nine patients with lower respiratory tract infection in hospital were selected as study group,including 27 cases of bacterial infection,32 cases of non-bacterial infection;and 58 healthy subjects were selected as the control group. Sputum specimens were callected from all patients and were cultured;and serum ESR,CRP,PCT level were detected. The levels of serum ESR,CRP and PCT were compared between the two groups. The levels of ESR,CRP and PCT in serum of patients with bacterial infection and non-bacterial infection were compared. The distribu-tion of pathogens in the study group was statistically analyzed. The sputum cultures,serum levels of ESR,CRP and PCT were detected and the clinical outcome of lower respiratory tract infection was con-firmed clinically. The clinical results were used as the ＂gold standard＂to compare the results of sputum culture,serum ESR,CRP,PCT levels,single detection and combined detection of lower respiratory tract infections. Results The levels of serum ESR,CRP and PCT in the study group were higher than those in the control group,and the differences were significant （P 〈 0. 05）. The levels of serum ESR,CRP and PCT in patients with bacterial infection were higher than those in patients with non bacterial infections, and the differences were significant （P 〈 0. 05）. There were 178 pathogens in the study group,including 4 cases of fungi,accounting for 2. 25%;81 cases of gram negative bacteria,accounting for 45. 51% and 93 cases of gram positive bacteria,accounting for 52. 24% . The sensitivity,specificity and accuracy of sputum culture,serum ESR,CRP and PCT levels were lower than those of single detection,and the differences were significant （P 〈 0. 05）. Conclusions The serum levels of ESR,CRP and PCT are higher in patients with lower respiratory tract infection,and the detection of serum ESR,CRP and PCT is helpful to identify the types of infection. Sputum culture combined with serum ESR,CRP and PCT levels in the diagnosis of lower respiratory tract infection can significantly improve the sensitivity,specificity and accuracy of the diagnosis,and the application value is higher.