联合血清PCT、CRP及IL-6检测对BSI诊断的临床价值分析

Clinical value of serum PCT,CRP and IL-6combined detection in diagnosis of BSI

目的研究血清降钙素原（PCT）、C反应蛋白（CRP）及白介素-6（IL-6）联合检测诊断细菌性血流感染（BSI）的临床价值。方法选取天津市宁河区医院2015年8月～2016年10月间收治的疑似细菌性BSI患者216例，入院后均送检血培养，根据培养结果将其分为阳性组（n=102）和阴性组（n=114）。检测血清PCT、CRP、IL-6水平，并比较2组患者的差异，同时计算出各指标及联合检测的灵敏度、特异度、准确度及阴阳预测值，并绘制ROC曲线评价各指标诊断价值。结果所有疑似BSI患者的细菌阳性检出率为47.22%；阳性组的血清PCT、CRP、IL-6水平均明显高于阴性组（P＜0.01）；IL-6的AUC均明显大于PCT和CRP（P＜0.05）；PCT、CRP及IL-6联合检测的灵敏度、特异度、准确度、阳性预测值、阴性预测值及约登指数均明显高于单项检测（P＜0.05）。结论血清PCT、CRP及IL-6对于细菌性BSI均有一定诊断价值，同时联合检测可明显提高诊断准确率，对早期诊断和治疗有重要作用。

Objective To study the serum procalcitonin(PCT),C reactive protein(CRP)and interleukin-6(IL-6)combined detection in the diagnosis of bacterial bloodstream infection(BSI)clinical value.Methods The subjects were216cases suspected of bacterial BSI patients in our hospital from August2015to October2016,all from the blood culture after admission,according to the result of culture will be divided into positive group(n=102)and negative group(n=114).Detection of serum PCT,CRP,IL-6level,and compared the difference between the two groups of patients,and calculate the sensitivity index and joint detection,specificity,accuracy and predictive value of yin and Yang,and draw the ROC curve to evaluate the diagnostic value of each index.The subjects were216cases suspected of bacterial BSI patients in our hospital from August2015to October2016,all from the blood culture after admission,according to the result of culture will be divided into positive group(n=102)and negative group(n=114).Detection of serum PCT,CRP,IL-6level,and compared the difference between the two groups of patients,and calculate the sensitivity index and joint detection,specificity,accuracy and predictive value of yin and Yang,and draw the ROC curve to evaluate the diagnostic value of each index.Results All patients with suspected BSI bacterial positive rate was47.22%;positive group of the serum PCT,CRP,IL-6levels were distinctly higher than negative group(P<0.01).IL-6of the AUC were significantly higher than that in PCT and CRP(P<0.05).PCT,CRP and IL-6combined detection of the sensitivity,specificity,accuracy,positive predictive value the negative predictive value,and Youden index were significantly higher than that of single detection(P<0.05).Conclusion The serum PCT,CRP and IL-6for bacterial BSI has a certain diagnostic value,combined with each index detection can significantly improve the accuracy of diagnosis,and plays an important role in early diagnosis and treatment.