血清炎症因子联合检测在发热感染性疾病诊断中的应用价值

Application value of combined detection of serum inflammatory factors in diagnosis of febrile infectious diseases

目的探讨血清炎症因子联合检测在发热感染性疾病诊断中的应用。方法选择2021年10月—2022年12月在天水市第一人民医院接受治疗的123例发热患者作为研究对象,其中发生细菌感染的82例患者纳入细菌组,未发生细菌感染的41例患者纳入非细菌组;另外选择同期在该院进行体检的50名健康志愿者作为对照组。采用速率散射免疫比浊法检测血清淀粉样蛋白A(SAA)、白细胞介素-6(IL-6)、C-反应蛋白(CRP),采用荧光分析仪检测降钙素原(PCT)。观察并比较各组上述指标水平和阳性率。结果细菌组和非细菌组的SAA、IL-6、CRP和PCT水平均明显高于对照组[SAA(mg/L):58.31±15.31、68.61±16.13比6.48±1.66,IL-6(ng/L):26.76±27.31、62.61±16.31比16.94±10.31,CRP(mg/L):120.31±1.61、28.64±0.12比6.43±0.62,PCT(μg/L):1.02±0.35、0.41±0.12比0.34±0.11,均P<0.05];细菌组SAA、IL-6水平均明显低于非细菌组,CRP、PCT水平均明显高于非细菌组(均P<0.05)。细菌组IL-6、CRP和PCT阳性率均明显高于非细菌组(IL-6:91.46%比31.71%,CRP:92.68%比56.10%,PCT:97.56%比7.32%,均P<0.05)。结论细菌组炎症因子水平与非细菌组比较差异均有统计学意义,在诊断细菌性感染发热患者具有一定价值,其中SAA/CRP比值可作为临床区分细菌感染和非细菌感染的判断依据,PCT可作为全身感染和脓毒症的确诊指标以及抗感染疗效观察的重要实验室诊断标志物,值得临床应用及推广。

Objective To investigate the application of combined detection of serum inflammatory factors in the diagnosis of febrile infectious diseases.Methods The 123 febrile patients treated in Tianshui First People's Hospital from October 2021 to December 2022 were selected as research objects,in which 82 paitents with bacterial infection were included as bacterial group and the others were included as non-bacterial group.Other 50 healthy volunteers undergoing physical examination at the same period were recruited as control group.Serum amyloid A(SAA),interleukin-6(IL-6)and C-reactive protein(CRP)were measured with rate scattering immunoturbidimetry and procalcitonin(PCT)was measured by fluorescence analyzer.The levels and positive rates of above indicators were compared among different groups.Results The levels of SAA,IL-6,CRP and PCT in bacterial group and non-bacterial group were higher than those in control group[SAA(mg/L):58.31±15.31,68.61±16.13 vs.6.48±1.66,IL-6(ng/L):26.76±27.31,62.61±16.31 vs.16.94±10.31,CRP(mg/L):120.31±1.61,28.64±0.12 vs.6.43±0.62,PCT(μg/L):1.02±0.35,0.41±0.12 vs.0.34±0.11,all P<0.05].The SAA and IL-6 levels in bacterial group were lower than those in non-bacterial group,while the CRP and PCT levels were higher(all P<0.05).The positive rates of IL-6,CRP and PCT in bacterial group were higher than those in non-bacterial group(IL-6:91.46%vs.31.71%,CRP:92.68%vs.56.10%,PCT:97.56%vs.7.32%,all P<0.05).Conclusions There are statistically significant differences in the levels of inflammatory factors between bacterial group and non-bacterial group,and the levels of inflammatory factors have certain diagnostic value for bacterial infection in fever patients.The SAA/CRP ratio could be used as basis for bacterial and non-bacterial infections diagnosis.PCT,the most important anti-infection marker,is useful for systemic infection and sepsis,and the findings in this study are worth clinical application and recommendation.