血清CRP、PCT及WBC在HAP细菌性感染者早期诊断中的临床诊断价值

The clinical diagnostic value of serum CRP, PCT and WBC in early diagnosis of HAP bacterial infection

目的：探析血清C反应蛋白（CRP）、降钙素原（PCT）、白细胞计数（WBC）在医院获得性肺炎（HAP）P细菌性感染者早期诊断中的临床诊断价值。方法i选取2016年3月～2018年3月在我院确诊后接受治疗的80例细菌性感染HAP患者和72例非细菌性感染患者作为本次研究的观察者和对照组。比较两组患者不同时刻的血清CRP、PCT、WBC及痰液PCT水平及其阳性检出率，比较革兰阴性菌患者与革兰阳性菌患者的血清CRP、PCT、WBC及痰液PCT水平。分析血清CRP、PCT、WBC在HAP细菌性感染者中的诊断效能。结果：T2时刻观察组患者的CRP水平明显高于对照组，T1时刻观察组患者的PCT水平明显高于对照组，T3时刻观察组患者的WBC值明显低于对照组（P〈0．05）。观察组患者的血清PCT及WBC阳性检出率均明显高于对照组（P〈0．05）。阴性组患者的血清CRP及PCT水平明显高于阳性组（P〈0．05）。血清PCT与WBC对HAP患者诊断的特异性明显高于血清CRP，血清PCT与WBC对HAP患者诊断的敏感性明显高于血清CRP（P〈0．05）。结论：血清CRP、PCT及WBC在HAP患者细菌性感染早期诊断中均具有一定的诊断效能．其中血清PCT水平的诊断价值最高。

Objective： To analyze the clinical dignositic value of the early diagnosis of the serum CRP, PCT and WBC in HAP patients with bacterial infection. Methods： 80 HAP patients with bacterial infection received treatment and 72 patients without bacterial infection at our hospital from March, 2016 to March, 2018 were analyzed, retrospectively. The level of serum CRP, PCT, WBC andsputum PCT at different times and the positive rates ofCRP, PCT, WBCand sputum PCT in two groups were compared. The level of the serum CRP, PCT, WBC and sputum PCT in gram-negative bacteria group and gram-positive bacteria group were compared. The diagnostic value of the serum CRP, PCT and WBC were analyzed. Results： The CRP level in observationgroup was obviously higher than that in control group at T2, the PCT level in observation group was higher than that in control group at Tt, the WBC value in observe group was lower than that in control group at T3 （P〈0.05） . The positive rates of PCT and WBC in observation group were significantly higher than those in control group （/}〈0.05） . The level of CRP and PCT in gram-negative bacteria group were higher than that in grampositive bacteria group （P〈0.05） . The specificity of the serum PCT and WBC in diagnosing HAP patients with bacterial infection were obviously higher than that of CRP, and the sensibility of the serum PCT and CRP were higher than that ofWBC （P〈0.05） . Conclusion： The detection of the serum CRP, PCT and WBC in HAP patients with bacterial infection has diagnostic value and PCT is the most instructive in clinical dignosis.