全血C反应蛋白与血常规联合检验在感染性疾病诊断中的价值研究

Study on the value of whole blood C-reactive protein combined with blood routine test in the diagnosis of infectious diseases

目的探究全血C反应蛋白与血常规联合检验在感染性疾病诊断中的价值。方法200例疑似感染性疾病患者,均行血常规、全血C反应蛋白检验,比较单独血常规检验、单独全血C反应蛋白检验及联合检验的诊断效能(诊断准确率、灵敏度、特异度)。另选取同期健康者200例作为对照,比较感染性疾病患者、健康者的血常规检验(白细胞计数、中性粒细胞百分比、血小板计数)、全血C反应蛋白检验结果;比较全身感染、局部感染患者的全血C反应蛋白、白细胞计数、中性粒细胞率、血小板计数。结果联合检验对感染性疾病的诊断准确率、灵敏度、特异度分别为99.50%、99.38%、100.00%,高于单独血常规检验的92.50%、94.44%、84.21%和单独全血C反应蛋白检验的94.50%、95.68%、89.47%,差异具有统计学意义(P<0.05)。实验室综合检验检出细菌性感染患者89例,病毒性感染患者73例。细菌性感染患者白细胞计数(17.34±2.15)×10^(9)/L、中性粒细胞百分比(83.54±3.24)%、血小板计数(364.24±34.24)×10^(9)/L、全血C反应蛋白(35.24±2.15)mg/L均明显高于健康者的(6.01±0.78)×10^(9)/L、(56.54±2.05)%、(186.24±10.15)×10^(9)/L、(6.24±1.01)mg/L,差异有统计学意义(P<0.05);病毒性感染患者全血C反应蛋白、血小板计数高于健康者,差异有统计学意义(P<0.05);病毒性感染患者白细胞计数、中性粒细胞百分比与健康者比较,差异无统计学意义(P>0.05);细菌性感染患者白细胞计数、中性粒细胞百分比、血小板计数、全血C反应蛋白均高于病毒性感染患者,差异有统计学意义(P<0.05)。全身感染48例,局部感染114例。全身感染患者全血C反应蛋白(40.24±3.24)mg/L、白细胞计数(22.15±2.34)×10^(9)/L显著高于局部感染患者的(27.66±3.15)mg/L、(12.01±1.48)×10^(9)/L,差异有统计学意义(P<0.05);全身感染患者与局部感染患者中性粒细胞百分比、血小板计数比较,差异无统计学意义(P>0.05)。结论全血C反应蛋白与血常规联合检验在感染性疾病临床诊断中具有很高价值,可以准确诊断,并鉴别区分细菌性感染、病毒性感染,同时可以评估感染程度。

Objective To investigate the value of whole blood C-reactive protein combined with blood routine test in the diagnosis of infectious diseases.Methods Blood routine test and whole blood C-reactive protein test were performed in 200 patients suspected of infectious diseases.The diagnostic efficacy(diagnostic accuracy,sensitivity and specificity)of blood routine and whole blood C-reactive protein alone and in combination were compared.Another 200 healthy subjects were selected as the controls to compare the results of blood routine test(white blood cell count,neutrophil percentage,platelet count)and whole blood C-reactive protein test between infectious disease patients and healthy subjects.The whole blood C-reactive protein,white blood cell count,neutrophil rate and platelet count were compared in patients with systemic infection and local infection.Results The diagnostic accuracy,sensitivity and specificity of combined test for infectious diseases were 99.50%,99.38%and 100.00%,which were higher than 92.50%,94.44%and 84.21%of routine blood test alone,and 94.50%,95.68%,89.47%of whole blood C-reactive protein test alone,and the differences were statistically significant(P<0.05).89 cases of bacterial infection and 73 cases of viral infection were detected by comprehensive laboratory examination.The white blood cell count(17.34±2.15)×10^(9)/L,neutrophil percentage(83.54±3.24)%,platelet count(364.24±34.24)×10^(9)/L,and whole blood C-reactive protein(35.24±2.15)mg/L in patients with bacterial infection were significantly higher than(6.01±0.78)×10^(9)/L,(56.54±2.05)%,(186.24±10.15)×10^(9)/L,(6.24±1.01)mg/L in healthy subjects,and the differences were statistically significant(P<0.05).The whole blood C-reactive protein and platelet count in patients with viral infection were higher than those in healthy subjects,and the difference was statistically significant(P<0.05).There was no statistically significant difference in white blood cell count and neutrophil percentage between viral infection patients and healthy subjects(P>0.05).The white blood cell count,neutrophil percentage,platelet count and whole blood C-reactive protein in patients with bacterial infection were all higher than those with viral infection,and the differences were statistically significant(P<0.05).There were 48 cases of systemic infection and 114 cases of local infection.The whole blood C-reactive protein(40.24±3.24)mg/L and white blood cell count(22.15±2.34)×10^(9)/L in patients with systemic infection were significantly higher than(27.66±3.15)mg/L and(12.01±1.48)×10^(9)/L in patients with local infection,and the differences were statistically significant(P<0.05).There was no statistically significant difference in neutrophil percentage and platelet count between patients with systemic infection and those with local infection(P>0.05).Conclusion The combined test of whole blood C-reactive protein and blood routine is of great value in the clinical diagnosis of infectious diseases,which can accurately diagnose,distinguish bacterial infection and viral infection,and assess the degree of infection.