血清PCT联合CRP检测对脓毒症的诊断价值

Diagnostic Value of Serum PCT Combined with CRP in Patients with Sepsis

目的探讨血清降钙素原(PCT)联合C反应蛋白(CRP)检测对脓毒症的诊断价值。方法选取2018年6月至2019年6月沈阳市第五人民医院收治的99例脓毒症患者作为研究对象,根据脓毒症严重程度分轻度脓毒症组(33例)、中度脓毒症组(33例)、重度脓毒症组(33例),选取同期的33例体检健康者作为对照组。比较各组受试者血清PCT、CPR水平变化,各指标受试者工作特征曲线(ROC曲线)变化以及诊断脓毒症的灵敏度、特异度。结果中度、重度脓毒症组患者血清PCT水平高于对照组[(3.15±1.02)μg/L、(11.34±3.55)μg/L比(0.31±0.09)μg/L](P<0.05),重度脓毒症组高于中度脓毒症组(P<0.05);轻度、中度、重度脓毒症组患者血清CPR水平高于对照组[(15.88±4.78)mg/L、(42.34±12.53)mg/L、(78.92±22.21)mg/L比(2.93±0.78)mg/L](P<0.05),中度和重度脓毒症组高于轻度脓毒症组(P<0.05),重度脓毒症组高于中度脓毒症组(P<0.05)。PCT联合CRP检测诊断脓毒症的曲线下面积(AUC)为0.893(95%CI 0.942~1.052),优于PCT、CRP单独检测的AUC[0.763(95%CI 0.816~1.002)、0.652(95%CI 0.682~0.987)]。PCT联合CRP检测诊断脓毒症的灵敏度、特异度分别为93.9%(62/66)和93.9%(31/33),高于PCT和CRP单独检测[90.9%(60/66)、63.6%(21/33),86.4%(57/66)、60.6%(20/33)]。结论血清PCT联合CRP检测脓毒症的灵敏度、准确度高于各指标单独检测,可有效判断患者病情严重程度及感染情况。

Objective To explore the diagnostic value of serum procalcitonin(PCT)combined with C-reactive protein(CRP)in patients with sepsis.Methods A total of 99 sepsis patients admitted to Shenyang Fifth People′s Hospital from Jun.2018 to Jun.2019 were included,and divided into a mild sepsis group(33 cases),a moderate sepsis group(33 cases),and a severe sepsis group(33 cases)according to the severity of sepsis.33 healthy people who received physical examination during the same period were included as a control group.The changes of serum PCT and CPR levels,the changes of receiver operating characteristic curve(ROC curve)of each index,and the sensitivity and specificity of sepsis diagnosis were compared between different groups.Results Serum PCT levels in the moderate and severe sepsis groups were higher than those in the control group[(3.15±1.02)μg/L,(11.34±3.55)μg/L vs(0.31±0.09)μg/L](P<0.05),and that in the severe sepsis group were higher than that in the moderate sepsis group(P<0.05).Serum CPR levels in the mild,moderate and severe sepsis groups were higher than that in the control group[(15.88±4.78)mg/L,(42.34±12.53)mg/L,(78.92±22.21)mg/L vs(2.93±0.78)mg/L](P<0.05),and the moderate and severe sepsis group were higher than that in the mild sepsis group(P<0.05),severe sepsis group higher than that in the moderate sepsis group(P<0.05).The area under curve(AUC)of PCT combined with CRP in the diagnosis of sepsis was 0.893(95%CI 0.942-1.052),which was better than that of PCT and CRP alone[0.763(95%CI 0.816-1.002),0.652(95%CI 0.682-0.987)].The sensitivity and specificity of PCT combined with CRP in the diagnosis of sepsis were 93.9%(62/66)and 93.9%(31/33),respectively,which were higher than that of PCT and CRP alone[90.9%(60/66)and 63.6%(21/33),86.4%(57/66)and 60.6%(20/33)].Conclusion Serum PCT combined with CRP has higher sensitivity and accuracy than either index alone in detecting sepsis,which can effectively judge the severity of the patient condition and infection.