C反应蛋白联合降钙素原诊断化脓性关节炎的临床价值

Clinical value of C-reactive protein combined with procalcitonin in the diagnosis of suppurative arthritis

目的探讨C反应蛋白(CRP)联合降钙素原(PCT)诊断化脓性关节炎的临床价值。方法回顾性分析我院2012年1月至2016年1月收治的骨关节炎患者162例的临床资料,其中非化脓性关节炎患者66例(对照组),化脓性关节炎患者96例(观察组)。检测两组患者的血清CPR及PCT水平,分析其早期表达与化脓性关节炎的相关性。结果观察组血清CRP和PCT水平显著高于对照组(P<0.05)。CRP诊断化脓性关节炎的AUC为0.935,灵敏度为79.2%,特异度为63.9%,准确度为72.8%,最佳阈值为8.42 mg/L;PCT诊断化脓性关节炎的AUC为0.926,灵敏度为81.3%,特异度为75.5%,准确度为79.0%,最佳阈值为4.2μg/L;CRP联合PCT诊断化脓性关节炎的AUC为0.981,灵敏度为86.5%,特异度为90.9%,准确度为88.3%。结论 CRP联合PCT诊断化脓性关节炎有很好的临床价值,可作为初筛检测指标。

Objective To explore the clinical value of C-reactive protein (CRP) combined with procalcitonin (PCT) in the diagnosis of suppurative arthritis.Methods The clinical data of 162 patients with osteoarthritis admitted in our hospital from January 2012 to January 2016 were retrospectively analyzed, included 66 patients with non-suppurative arthritis (control group) and 96 patients with suppurative arthritis(observation group).The levels of CPR and PCT in serum of the two groups were detected, and the correlation between early expressions of CPR, PCT and suppurative arthritis were analyzed.Results The levels of CRP and PCT in the observation group were significantly higher than those in the control group(P<0.05).The ACU, sensitivity, specificity and accuracy of CRP in the diagnosis of suppurative arthritis were 0.935, 79.2%, 63.9% and 72.8%, and the optimal threshold was 8.42 mg/L.The AUC, sensitivity, specificity and accuracy of PCT in the diagnosis of suppurative arthritis were 0.926, 81.3%, 75.5% and 79.0%, and the optimal threshold was 4.2 μg/L.The AUC, sensitivity, specificity and accuracy of CRP combined with PCT in the diagnosis of suppurative arthritis were 0.981, 86.5%, 90.9% and 88.3%.Conclusion CRP combined with PCT has a good clinical value in the diagnosis of suppurative arthritis, and can be used as a primary screening indicator.