ICU重症感染患者PCT和CRP的变化与诊断价值研究

Changes of PCT and CRP and their diagnostic value in patients with severe ICU infection

目的分析ICU重症感染患者外周血降钙素原(PCT)、C-反应蛋白(CRP)的变化对疾病的诊断价值。方法选取2015年7月-2017年10月医院收治的100例ICU重症患者,其中50例ICU重症感染患者设为研究组,而50例非感染性ICU患者设为对照组,观察两组的PCT、CRP水平。结果研究组抗感染第3、5、7天PCT和CRP分别为(1.38±0.33)、(0.97±0.28)、(0.46±0.12)ng/L和(15.32±3.28)、(11.47±2.61)、(8.02±1.89)mg/L高于对照组,两组抗感染治疗后PCT和CRP值均下降,差异具有统计学意义(P均<0.05)。研究组中,PCT含量2.1~10 ng/L的患者数为35例,0.5~2.0 ng/L患者为14例,阳性率为98.00%,对照组中,PCT含量0.5~2.0 ng/L的患者数为5例,阳性率为10.00%;在两组CRP含量分析中,研究组CRP含量>10 mg/L,其中32例患者CRP含量>20 mg/L,18例在10~20 mg/L之间,阳性率达100.00%,对照组非感染ICU患者外周血中,CRP含量在10~20 mg/L间患者42例,<10 mg/L患者8例,阳性率达84.00%。PCT和CRP两项指标诊断ICU重症患者感染的灵敏度、阴性预测值无统计学差异;CRP诊断ICU重症患者感染的特异度(84.00%)高于PCT诊断的特异度(10.00%)(P<0.001);PCT诊断ICU重症患者感染的阳性预测值(90.70%)高于CRP诊断的阳性预测值(54.30%)(P<0.001)。结论 ICU重症患者外周血PCT和CRP的变化,是区分感染的重要指标,外周血PCT和CRP的变化能指导临床采取合适的措施,从而提高ICU重症患者的生存率。

OBJECTIVE To analyze the changes of peripheral blood procalcitonin(PCT)and high-sensitivity C-reactive protein(hs-CRP)and their diagnostic value in patients with severe ICU infection.METHODS One hundred critically ill ICU patients admitted to the hospital from Jul.2015 to Oct.2017 were selected.Among them,50 patients with severe ICU infection were set as the study group,and 50 non-infective ICU patients were included as the control group.The PCT and CRP levels in the two groups were observed.RESULTS The PCT and CRP of the study group were(1.38±0.33),(0.97±0.28),(0.46±0.12)ng/L and(15.32±3.28),(11.47±2.61),(8.02±1.89)mg/L on the 3 rd,5 th and 7 th day of anti-infection,respectively,higher than those of the control group.The PCT and CRP values of the two groups decreased significantly after anti-infection treatment(P<0.05).In the study group,35 patients had PCT content of 2.1-10 ng/L,14 patients had PCT content of 0.5-2.0 ng/L,and the positive rate was 98.00%.In the control group,5 patients had PCT content of 0.5-2.0 ng/L,and the positive rate was 10.00%.The CRP content in the study group was more than 10 mg/L,32 patients had CRP content of 20 mg/L,18 patients had CRP content of 10-20 mg/L,and the positive rate was 100.00%.In the peripheral blood of patients in the control group,the CRP content ranged from 10 to 20 mg/L in 42 patients and less than 10 mg/L in 8 patients,with a positive rate of 84.00%.There was no significant difference in sensitivity and negative predictive value between PCT and CRP in the diagnosis of ICU severe infections.The specificity of CRP in the diagnosis of ICU severe infections(84.00%)was significantly higher than that of PCT(10.00%)(P<0.001),and the positive predictive value of PCT in the diagnosis of ICU severe infections(90.70%)was significantly higher than that of CRP(54.30%)(P<0.001).CONCLUSION The change of peripheral blood PCT and CRP in ICU critical patients is a significant indicator of non-infected ICU.The changes in the patient’s peripheral blood PCT and CRP levels can instruct the doctor to take the right measures,so as to improve the survival rate of ICU critical patients.