血清PCT、IL-6联合超敏CRP检测对产后革兰氏阴性杆菌感染早期诊断的价值

Early diagnostic value of joint determination of hs-CRP, IL-6 and PCT in postpartum infection of Gram-negative bacillus

目的探讨血清降钙素原(PCT)、白细胞介素-6(IL-6)联合超敏C反应蛋白(hs-CRP)检测早期诊断产后革兰氏阴性杆菌感染的临床价值。方法选取2014年9月至2015年9月期间在我院妇产科实行剖宫产分娩,且经临床表现及细胞培养证实为革兰氏阴性杆菌感染者100例(观察组),另选取我院自然分娩的健康产妇100例(对照组),各种标本培养均为阴性,对所有产妇的血清PCT、IL-6、hs-CRP水平和阳性率,以及三者的敏感度、特异度和细菌感染诊断价值进行测定。结果观察组产妇血清PCT、IL-6和hs-CRP水平分别为(3.58±0.15)ng/m L、(39.25±6.08)ng/L和(14.37±2.31)mg/L,均高于对照组的(0.36±0.11)ng/m L、(12.83±5.12)ng/L和(3.21±0.03)mg/L,差异均有统计学意义(P<0.05);观察组产妇PCT、IL-6、hs-CRP阳性率分别为76.0%(76/100)、72.0%(72/100)和43.0%(43/100),均明显高于对照组的8.0%(8/100)、15.0%(15/100)和4.0%(4/100),差异均有统计学意义(P<0.05);PCT的敏感度为81.7%,特异度为95.75%;IL-6的敏感度为92.5%,特异度为60.3%;hs-CRP的敏感度为70.9%,特异度为92.2%。其中,IL-6的敏感度最高,PCT和hs-CRP的特异度均较高。结论血清PCT、IL-6联合hs-CRP检测对诊断产妇产后是否有革兰氏阴性杆菌感染有一定的临床价值。

Objective To investigate the early diagnostic value of joint determination of high-sensitivity C-reactive protein(hs-CRP), interleukin-6(IL-6) and procalcitonin(PCT) in post postpartum infection of Gram-negative bacillus. Methods The clinical records of 100 patients with Gram-negative bacillus infection after cesarean section in the Department of Gynecology and Obstetrics in our hospital between September 2014 and September 2015 were selected as case group. And 100 women of spontaneous labor in our hospital without infection were selected as control group. The serum levels of PCT, IL-6, hs-CRP and the positive rate of all the women were measured. The sensitivity, specificity and diagnostic value of bacterial infection were determined. Results The serum levels of PCT, IL-6 and hs-CRP in the case group were(3.58±0.15) ng/m L,(39.25±6.08) ng/L and(14.37±2.31) mg/L, which were significantly higher than those in the control group of(0.36±0.11) ng/m L,(12.83±5.12) ng/L,(3.21±0.03) mg/L(P<0.05). The positive rates of PCT, IL-6and hs-CRP in the case group were 76.0%(76/100), 72.0%(72/100), 43.0%(43/100), which were significantly higher than those in the control group of 8.0%(8/100), 15.0%(15/100), 4.0%(4/100), with P<0.05. The sensitivity and specificity was 81.7% and 95.75% for PCT, 92.5% and 60.3% for IL-6, 70.9% and 92.2% for hs-CRP. The sensitivity of IL-6was the highest, and the specificity of PCT and hs-CRP were high. Conclusion Joint determination of hs-CRP, IL-6and PCT in postpartum infection of Gram-negative bacillus has certain clinical value.