降钙素原与血清和肽素及C-反应蛋白联合检测在脑出血肺部感染患者早期诊断中的价值和意义

Value and significance of joint detection of procalcitonin,serum and peptide and C-reactive protein in early diagnosis of cerebral hemorrhage patients complicated with pulmonary infections

目的探讨降钙素原、血清和肽素以及C-反应蛋白联合检测在脑出血并发肺部感染患者早期诊断中的临床价值。方法选取2016年1月-2017年2月医院就诊并确诊为脑出血患者98例,按是否合并肺部感染分为非感染组62例和感染组36例,采用酶联免疫吸附法(ELISA)测定两组患者血清和肽素及血清降钙素原水平;采取免疫荧光干式定量分析法,测定患者血清C-反应蛋白水平,比较两组患者发病后6h、24h、7d血清和肽素、降钙素原、C-反应蛋白水平,并比较不同指标的敏感度和特异度。结果感染组发病后6h、24h、7d血清和肽素、降钙素原、C-反应蛋白水平均高于非感染组(P<0.05);将感染组发病后6h、24h、7d不同时间阶段血清和肽素、降钙素原、C-反应蛋白指标作为基础数据绘制ROC曲线,血清和肽素的敏感度、特异度分别为72.22%、83.33%,降钙素原的敏感度、特异度分别为88.89%、75.00%,C-反应蛋白敏感度、特异度分别为86.11%、77.78%,三个指标联合检测的敏感度、特异度分别为88.89%、94.44%。结论采取血清和肽素、降钙素原和C-反应蛋白联合检测的方式,可对脑出血并发肺部感染疾病进行早期诊断和鉴别,可明确指导肺部感染疾病选择合适的抗菌药物治疗。

OBJECTIVE To explore the clinical value of joint detection of procalcitonin（PCT）,serum and peptide and C-reactive protein（CRP）in early diagnosis of cerebral hemorrhage patients complicated with pulmonary infection.METHODS A total of 98 patients who were diagnosed with cerebral hemorrhage from Jan 2016 to Feb 2017 were enrolled in the study and divided into the non-infection group with 62 cases and the infection group with 36 cases according to the status of pulmonary infections.The levels of serum and peptide and serum PCT of the two groups of patients were detected by means enzyme-linked immunosorbent assay（ELISA）,the serum CRP level was detected by using immunofluorescence dry quantitative analysis method.Th levels of serum and peptide,PCT and CRP were compared between the two groups of patients after the attack for 6 hours,24 hours and 7 days,and the sensitivity and specificity were observed and compared among the indexes.RESULTS The levels of serum and peptide,PCT and CRP of the infection group were significantly higher than those of the non-infection group after the attack for 6 hours,24 hours and 7 days（P〈0.05）.The ROC curve was drawn based on the data of serum and peptide,PCT and CRP of the infection group after the attack for 6 hours,24 hours and 7 days.The sensitivity of the serum and peptide was 72.22%,the PCT 88.89%,the CRP 86.11%,the joint detection of the three indexes88.89%;the specificity of the serum and peptide was 83.33%,the PCT 75.00%,the CRP 77.78%,the joint detection of the three indexes 94.44%.CONCLUSIONThe joint detection of serum and peptide,PCT and CRP may facilitate the early diagnosis and identification of pulmonary infectious diseases in the patients with cerebral hemorrhage and prove guidance for reasonable use of antibiotics.