血清降钙素原、白细胞计数、C-反应蛋白与细菌血培养联合检测在感染患者中的应用价值

Application value of serum procalcitonin,white blood cell count,C-reactive protein combined with bacterial blood culture detection on infected patients

目的分析探讨血清降钙素原(PCT)、白细胞计数(WBC)、C-反应蛋白(CRP)与细菌血培养联合检测在感染患者中的应用价值。方法收集2014年12月～2017年12月梧州市人民医院住院的153例感染患者,根据血培养结果,将患者分为血培养阳性组和血培养阴性组,再将血培养阳性组分为革兰阳性球菌组与革兰阴性杆菌组及其他菌组,选择同期正常健康体检者100例为对照组。对所有研究对象进行PCT、WBC、CRP检测,然后将检测结果进行比较分析。结果 153例感染患者中,血培养阳性72例(血培养阳性组),阴性81例(血培养阴性组)。血培养阳性组PCT、WBC、CRP水平高于血培养阴性组,且血培养阳性组和血培养阴性组PCT、WBC、CRP水平高于对照组,差异有统计学意义(P<0.05)。血培养阳性组中革兰阴性杆菌感染48例,革兰阳性球菌感染13例,其他菌种11例;革兰阳性球菌组PCT、WBC水平与革兰阴性杆菌组、其他菌组比较,差异无统计学意义(P>0.05),CRP水平比较差异有统计学意义(P<0.05),革兰阴性杆菌组与其他菌组的PCT、WBC、CRP水平比较,差异无统计学意义(P>0.05)。结论 PCT、WBC、CRP是细菌感染的检测指标,但并不能很好的区分哪种细菌,联合血培养检测,对细菌感染患者的诊治及疗效有着重要的临床应用价值。

Objective To analyze the value of serum procalcitonin（PCT）, white blood cell count（WBC）, C-reactive protein（CRP） combined with bacterial blood culture in the detection on infectious patients. Methods From December 2015 to December 2017, 153 infected patients in People＇s Hospital of Wuzhou were selected. According to blood culture results, patients were divided into blood culture positive group and blood culture negative group, the blood culture positive group were Gram-positive coccus group, Gram-negative bacillus group and other miscellaneous bacteria group,100 normal healthy people were selected as control group at the same periord. All objects were given PCT, WBC, and CRP examination, then the results were compared and analyzed. Results Among 153 infected patients, 72 cases were blood culture positive（blood culture positive group）, 81 cases were blood culture negative（blood culture negative group）. The levels of PCT, WBC, CRP in blood culture positive group were higher than the blood culture negative group, and the levels of PCT, WBC, CRP in the blood culture positive group and blood culture negative group were higher than normal control group, the differences were statistically significant（P〈0.05）. There were 48 cases were Gram-negative bacilli in the blood culture positive group, 13 cases were Gram-positive cocci, and 11 cases were other strains. The levels of PCT and WBC in Gram-positive cocci group were compared with Gram-negative bacilli group,other strains group, the differences were not statistically significant（P〈0.05）, CRP levels were comapred, the differences were statistically significant（P〈0.05）, the levels of PCT, WBC, CRP in Gram-negative bacilli group were compared with other strains group, the differences were not statistically significant（P〈0.05）. Conclusion PCT, WBC and CRP are indicators of bacterial infection, but it is not a good way to distinguish which type of bacteria. The combined blood culture test has important clinical application value for diagnosis and treatment of bacterial infection.