PCT、CRP、IL-6在鉴别诊断脓毒血症和SIRS中的应用价值

Application value of PCT,CRP and IL-6 in differential diagnosis of sepsis and SIRS

目的:探讨血清降钙素原(PCT)、C反应蛋白(CRP)、白细胞介素-6(IL-6)联合检测鉴别诊断脓毒血症与全鼻炎症反应综合征(SIRS)的临床价值。方法:收集2015年6月~2018年6月我院重症监护室(ICU)收治的47例脓毒血症患者及55例SIRS患者,所有患者均于入ICU24h内行血清PCT、CRP、IL-6水平检测。应用受试者工作特征曲线分析血清PCT、CRP、IL-6及三项联合检测鉴别诊断脓^血症和SIRS的临床价值。结果:脓毒血症患者血清PCT、CRP、IL-6水平分别为(6.36±1.76)μg/L、(86.47±21.45)mg/L、(61.23±16.84)ng/L,均明显高于SIRS患者的(0.96±0.25)μg/L、(32.34±9.24)mg/L、(23.17±5.87)ng/L(P<0.05)。ROC曲线分析显示,血清PCT、CRP、IL-6三项联合诊断脓毒血症的曲线下面积为0.829,敏感度为85.1%,特异度为90.9%,准确度为80.4%,较各单项检测明显提高特异度(P<0.05)。结论:血清PCT、CRP、IL-6联合检测对鉴别诊断脓毒血症与SIRS有较高价值。

Objective:To explore the clinical value of combined detection with serum procalcitonin(PCT),C—reactive protein(CRP)and interleukin-6(IL-6)in differential diagnosis of sepsis and systemic inflammatory response syndrome(SIRS).Methods:47 sepsis patients and 55 SIRS patients who were admitted to intensive care unit(ICU)of the hospital from June 2015 to June 2018 were enrolled.All patients were tested for serum PCT,CRP and IL-6 levels within 24h after entering to ICU.The receiver operating characteristic(ROC)curves were performed to analyze clinical value of serum PCT,CRP,IL-6 and their combination for differential diagnosis of sepsis and SIRS.Results:The levels of serum PCT,CRP and IL-6 in sepsis patients were(6.36±1.76)μg/L,(86.47±21.45)mg/L and(61.23±16.84)ng/L,respectively,which were sigrdficandy higher than those in SIRS patients[(0.96±0.25)μg/L,(32.34±924)mg/L,(23.17±5.87)ng/L](P<0.05).ROC curves analysis showed that area under the curve(AUC),sensitivity,specificity and accuracy of combination detection with serum PCT,CRP and IL-6 for diagnosis of sepsis were 0.829,85.1%,90.9%and 80.4%,respectively.The specificity of combination detection was significantly higher than that of single detection(P<0.05).Conclusion:The combination detection with serum PCT,CRP and IL-6 is of relatively higher clinical value in differential diagnosis of sepsis and SIRS.