慢性肾功能衰竭合并感染患者血清C反应蛋白、降钙素原及白细胞计数水平及其临床意义

The levels of serum CRP,PCT and WBC count and their clinical significance in patients with chronic renal failure complicated with infection

目的探讨慢性肾功能衰竭(CRF)合并感染患者血清C反应蛋白(CRP)、降钙素原(PCT)及白细胞(WBC)计数水平及其临床意义。方法选取56例CRF合并感染患者(感染组),同期56例CRF非感染患者(非感染组)和56例正常体检者(对照组),比较三组血清CRP、PCT、WBC计数水平及阳性检出率,以CRP、PCT、WBC计数水平阳性结果为感染阳性,分析其对CRF合并感染的诊断效能,绘制ROC曲线分析各指标对CRF合并感染的预测价值。结果感染组血清CRP、PCT、WBC计数水平及阳性检出率均高于非感染组和对照组(P<0.05);PCT诊断CRF合并感染的灵敏度、特异度、准确度、阳性预测值、阴性预测值最高,分别为0.929、0.946、0.938、0.945、0.930;CRP、PCT、WBC计数的ROC曲线下面积分别为0.958、0.964、0.936。结论CRF合并感染患者血清CRP、PCT及WBC计数水平均上升,血清CRP、PCT及WBC计数水平对CRF合并感染有较高的预测价值。

Objective To analyze the levels of serum Creactive protein(CRP),procalcitonin(PCT)and white blood cells(WBC)count and their clinical significance in patients with chronic renal failure(CRF)complicated with infection.Methods Fifty six patients with CRF and infection admitted to our hospital were set as infection group.Another 56 patients with CRF and non infection at the same period were selected as non infection group.In addition,56 normal examiners were set as control group.The levels and positive rate of CRP,PCT and WBC count were compared among the three groups.The positive results of CRP,PCT and WBC count were taken as positive infection,and the diagnostic efficacy of them on CRF with infection was analyzed.ROC curve was drawn to analyze the predictive value of each index for CRF with infection.Results The levels of serum CRP,PCT and WBC count in the infection group were significantly higher than those in the non infection group and the control group(P<0.05).The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of PCT were 0.929,0.946,0.938,0.945 and 0.930,respectively and the highest in diagnosis of CRF with infection among the three indexes.The values of area under the ROC curve of CRP,PCT and WBC count were 0.958,0.964 and 0.936,respectively.Conclusion The levels of serum CRP,PCT and WBC count of patients with CRF and infection are significantly increased.Levels of serum CRP,PCT and WBC count have a relative high predictive value for CRF with infection.