PCT、CRP、WBC及NLR在老年人群细菌感染性疾病中的诊断价值

Diagnostic value of PCT, CRP, WBC and NLR in bacterial infectious diseases in elderly

目的探讨PCT(降钙素原)、CRP(C-反应蛋白)、WBC(白细胞总数)及NLR[中性粒细胞计数(NEUT)/淋巴细胞计数(LYMPH)比值],在老年人群细菌感染性疾病中的诊断价值。方法分别检测细菌性感染患者59例,非细菌性感染患者53例和42例健康人群的PCT、CRP、WBC及NLR水平,分析各组指标的差异。利用ROC曲线评价各指标在老年人群细菌性感染疾病的诊断价值。结果细菌感染组分别与其他2组比较,PCT、CRP、WBC及NLR水平均高于其他两组,且差异有统计学意义(P<0.05)。4项指标的ROC曲线下面积分别为0.961、0.812、0.808和0.795。其中PCT特异性最高,为92.6%,CRP的灵敏度最高,为93.2%。4个参数联合诊断ROC曲线下面积为0.973,特异性为91.6%,灵敏度为91.5%。对老年人群细菌感染组患者住院治疗前后PCT、CRP、WBC及NLR水平变化研究发现,4项指标水平随着治疗的进程逐渐下降,差异有统计学意义(P<0.05)。结论 PCT、CRP、WBC及NLR在诊断老年人群细菌性感染疾病中均具有诊断价值。其中PCT的诊断特异性较高,与细菌性感染程度的相关性更强。4项指标联合诊断效能明显优于单项检测。

Objective To explore the diagnostic value of procalcitonin(PCT), C-reactive protein(CRP), white blood cell count(WBC) and NLR in bacterial infectious diseases in the elderly. Methods The levels of PCT, CRP, WBC and NLR from 59 patients with bacterial infections, 53 patients with non-bacterial infections, and 42 healthy people were respectively detected and the results were analyzed statistically. The diagnostic value of each indicator in bacterial infection diseases of the elderly patients was evaluated by ROC curve. Results The levels of PCT, CRP, WBC and NLR in the bacterial infection patients were higher than those in the other two groups, and the difference was statistically significant(P < 0.05).The areas under the ROC curve of the four indicators were 0.961, 0.812, 0.808 and 0.795 respetively. Among them, PCT had the highest specificity,which was 92.6% and CRP had the highest sensitivity, which was 93.2%.The area under the ROC curve of the combined detection of the four indicators was 0.973, the specificity was 91.6%, and the sensitivity was 91.5%. The studies on the changes of PCT, CRP, WBC and NLR levels before and after hospitalization in the bacterial infection group of the elderly patients found that the levels of the four indicators gradually decreased with the treatment process, and the differences were statistically significant(all P < 0.05). Conclusion The detection of PCT, CRP, WBC and NLR can be used for the diagnosis of bacterial infections in the elderly.The highest diagnostic specificity is PCT,which is more closely related to the degree of bacterial infections. The combined diagnostic efficiency of the four indicators is significantly better than that of the respective indicator。