降钙素原等多项指标联合检测对老年患者抗细菌感染价值分析  

Anti-infection value of combined determination of serum levels of procalcitonin, C-reactive protein, prealbumin, white blook cell in the elderly with bacterial infection

作　　者：刘怀平[1] 张健东[1] 丁贤[1] 周淑芬[1] 刘树业[1] 

机构地区：[1]天津市第三中心医院医学检验中心,300170

出　　处：《中华老年医学杂志》2012年第10期863-866,共4页Chinese Journal of Geriatrics

摘　　要：目的评价联合检测降钙素原（PCT）、C反应蛋白（CRP）、前白蛋白（PA）、白细胞（WBC）水平的改变在老年患者细菌感染疗效观察及预后判断中的临床意义。方法对重症监护病房（ICU）的70例细菌感染患者血清PCT、CRP、PA、WBC的含量及动态变化进行监测，同时将70例细菌感染患者分为重症感染组（42例）和局部感染组（28例），并与病毒感染组（30例）进行比较分析。结果重症感染组（PCT（18．00±3．20）μg／L、CRP（86．17±10．64）mg／L]和局部感染组（PCT（2．03±0．46）μg／L、CRP（50．24±7．45）mg／L]血清PCT、CRP浓度均明显升高，PA明显降低[（3．21±0．88）mg／L、（12．89±1．03）mg／L]，WBC轻度升高[（8．89±1．23）×10。／L、（6．54±0．87）×10^9／L]，与病毒感染组（PCT（0．21±0．06）μg／L、CRP（5．21±0．84）mg／L、PA（20．14±2．57）mg／L,WBC（5．30±0．93）×10。／L]比较，差异均有统计学意义（P〈O．01）；重症感染组与局部感染组比较，差异均有统计学意义（P〈0．01）。经有效抗菌药物治疗后，细菌感染组患者PCT（0．5±0．08）μg／L、CRP（10．32±1．65）mg／L、WBC（6．30±0．91）×10^9／L水平明显下降，PA（18．19±2．66）mg／L明显上升，与治疗前（PCT（11．61±8．27）μg／L、CRP（71．80±20．09）mg／L、WBC（7．95±1．59）×10^9／L PA（7．08±4．87）mg／L]比较，差异有统计学意义（P％0．01）。细菌感染组与病毒感染组患者治疗前、后PCT与其他指标的相关性分析显示，细菌感染组PCT与CRP、PA在治疗前（r=0．586、0．445）治疗后（r=0．688、0．463）均呈正相关，与WBC治疗后呈正相关（r=0．432）；病毒感染组PCT与各指标治疗前后均不相关（r％0．306）；比较PCT、CRP两者对于细菌感染性疾病诊断的敏感性和特异性，两者敏感性相近（95．7％），特异性PCT显著高于CRP（Objective To evaluate the clinical significance of the combined determination of serum procalcitonin （PCT）, C reactive protein（CRP）, prealbumin（PA）and white blood cell（WBC）in curative effect and prognosis of elderly patients with bacterial infection. Methods Serum PCT, CRP, PA and WBC levels and their dynamic changes of 70 patients with bacterial infection from intensive care unit（ICU）were measured. The patients with bacterial infection were classified into serious infection group and local infection group. And the comparison with virus infection group was made. Results The levels of PCT（18.00±3.20）/,g/L and CRP（S6.17± 10.64 ）mg/L in serious infection group and local infection group（PCT（2.03± 0.46） μg/L, CRP（50.24±7.45） mg/L3 were increased. The contents of PA were reduced（（3.21±0.88）mg/L,（12.89±1.03）mg/L3. The levels of WBC were increased mildly（（8.89±1.23））〈 10^9/L,（6.54±0.87） ）〈 10^9/L3. The differences were statistically significant between bacterial infection groups （serious infection group and local infection group） and virus infection group（PCT（0.21± 0.06） μg/L, CRP（5.21±0.84 ） mg/L,PA（20. 14± 2.57）mg/L,WBC（5.30±0.93）×10^9/L.） （P〈 0.01）. Serum PCT, CRP, PA and WBC showed significant differences between serious infection group and local infection group （P〈0.01）. After antibiotic treatment, the levels of PCT （0.5 ± 0.08）/,g/L, CRP （10.32 ± 1.65 ） mg/L and WBC （6.30 ±0.91）× 10^9/L in bacterial infection group were reduced obviously and the concentration of PA （ 18.19 ± 2.66 ） mg/L was elevated compared with before treatment （PCT （ 11.61 ± 8.27 ）/,g/L, CRP （71.80±20.09）mg/L,WBC（7.95±1.59）×109/L,PA（7.08±4.87）mg/L） （P〈0. 01）. Correlative analysis was performed between PCT and others indicators before and after antibiotic treatment in bacterial infection group and virus infection group. There was positive correlation between PCT and CRP, WBC befor

关 键 词：降钙素原 C反应蛋白 前白蛋白 细菌感染 

分 类 号：R446.5[医药卫生—诊断学]