慢性肾衰竭合并感染患者早期联合检测血清降钙素原、超敏C-反应蛋白、血清淀粉样蛋白A和白细胞的临床价值

Clinical value of early combined detection of PCT, Hs-CRP, SAA and WBC in patients with chronic renal failure co-infection

目的研究慢性肾衰竭合并感染患者血清降钙素原(PCT)、超敏C-反应蛋白(Hs-CRP)、血清淀粉样蛋白A(SAA)和白细胞(WBC)检测的临床价值及应用分析,为临床用药治疗提供科学依据。方法采用回顾性分析丽水市中心医院肾内科2015年1月-2017年12月慢性肾衰竭合并感染的住院患者200例,男、女各100例,分为细菌感染组105例、病毒感染组95例,另选取健康体检者为健康对照组50例,检测血清中PCT、Hs-CRP、SAA和WBC结果。结果慢性肾衰竭合并细菌感染组患者的PCT、Hs-CRP、SAA和WBC均明显高于健康对照组和病毒感染组,差异有统计学意义(P<0.05);病毒感染组与健康对照组相比,PCT、Hs-CR、WBC差异无统计学意义(P>0.05),SAA的差异有统计学意义(P<0.05)。细菌感染组SAA的阳性率与病毒感染组差异无统计学意义(P>0.05)。结论早期联合检测PCT、Hs-CRP、SAA和WBC可以有效鉴别慢性肾衰患者感染性疾病,具有显著的诊断价值,对细菌感染性诊断具有很好的敏感度和特异性,为临床治疗提供可靠依据。

Objective To investigate the clinical value and application analysis of serum procalcitonin(PCT),high sensitivity C-reactive protein(Hs-CRP),serum amyloid A(SAA)and white blood cell(WBC)in patients with chronic renal failure(CRF)complicated with infection,so as to provide scientific basis for clinical medication.Methods A total of 200 inpatients with chronic renal failure complicated with infection including 100 males and 100 female were collected from January 2015 to December 2017,and divided into the bacterial infection group(105 cases)and virus infection group(95 cases).Meanwhile,50 healthy people were enrolled in the control group.The serum PCT,Hs-CRP,SAA and WBC were detected.Results PCT,Hs-CRP,SAA and WBC in the chronic renal failure complicated with bacterial infection group were significantly higher than those in viral infection group and control group,with the differences statistically significant(P<0.05).There was no statistical significance on the difference in PCT,Hs-CR and WBC between the virus infection group and the control group(P>0.05),so was the difference of SAA(P<0.05).There was no statistical significance on the difference in the positive rate of SAA between the bacterial infection group and the virus infection group(P>0.05).Conclusion The early combined detection of PCT,Hs-CRP,SAA and WBC could effectively identify infectious diseases in patients with chronic renal failure,and had significant diagnostic value.It had good sensitivity and specificity for the diagnosis of bacterial infections,and provided reliable evidence for clinical treatment.