降钙素原和C-反应蛋白检测在感染性腹泻诊断中的临床价值

Clinical detection value of procalcitonin and C-reactive protein in the diagnosis of infectious diarrhea

目的探讨降钙素原(PCT)和C-反应蛋白(CRP)检测在感染性腹泻诊断中的意义。方法对2015年1月-2017年9月消化内科收治的151例感染性腹泻患者进行回顾性分析。结果细菌性腹泻组PCT和CRP水平较病毒性腹泻组、对照组均明显升高(P<0.05);病毒性腹泻组二者水平与对照组比较则均无意义(P>0.05)。经有效治疗后,细菌性腹泻组二者水平均显著下降(P<0.05),病毒性腹泻组二者水平变化不明显(P>0.05),细菌性腹泻组二者的阳性率明显高于其他2组,上述差异均有统计学意义(P<0.05)。PCT对诊断细菌性腹泻的灵敏度、特异度、阳性预测值和阴性预测值分别为85.5%、95.0%、95.9%和82.6%,均高于CRP。治疗前细菌性腹泻组PCT与CRP水平呈正相关(r=0.792,P<0.01)。结论联合检测PCT和CRP水平对细菌性腹泻的早期诊断、鉴别诊断及预后评估具有重要意义,且PCT的诊断效率优于CRP。

Objective To investigate the clinical significance of procalcitonin（ PCT） and C-reactive protein（ CRP） in the diagnosis of infectious diarrhea. Methods A retrospective analysis was conducted on the patients with infectious diarrhea admitted to Department of Gastroenterology during January 2015-September 2017. Results The levels of PCT and CRP in bacterial diarrhea group were significantly higher than that in viral diarrhea group and healthy control group（ P〈0. 05）; the differences of them between the viral diarrhea group and the control group were statistically significant（ P〉0. 05）. After treatment,the levels of them in bacterial diarrhea group significantly decreased（ P〈0. 05）,the levels of them in viral diarrhea group changed not so significantly（ P〉0. 05）,the positive rates of them in bacterial diarrhea group was also significantly higher than that in the other two groups,with the differences above all statistically significant（ P〈0. 05）. The sensitivity,specificity,positive predictive value and negative predictive value of PCT in the diagnosis of bacterial diarrhea were 85. 5%,95. 0%,95. 9% and 82. 6%,respectively,which were all higher than CRP. Correlation analysis showed a positive correlation between PCT and CRP levels in patients with bacterial diarrhea before treatment（ r = 0. 792,P〈0. 01）. Conclusion Combined detection of PCT and CRP levels were of great significance in the early diagnosis,differential diagnosis and prognosis of bacterial diarrhea,and the diagnostic efficiency of PCT was better than CRP.