感染性心内膜炎患者血清C-反应蛋白与降钙素原的变化及临床意义  

Clinical significance of serum C-reactive protein and procalcitonin in patients with infective endocarditis

作　　者：卢芬[1] 胡湘明[1] 李晓明[1] 廖火生[1] 喻志宏[1] 黄德仪[1] 翁小平[1] 林蔡第 何朝生[2] 

机构地区：[1]广东省人民医院广东省医学科学院平洲分院内科,广东广州510000 [2]广东省人民医院广东省医学科学院平洲分院肾内科,广东广州510000

出　　处：《中华医院感染学杂志》2014年第13期3376-3377,3380,共3页Chinese Journal of Nosocomiology

基　　金：广东省科技计划基金资助项目(2007B031507008)

摘　　要：目的探讨血清C-反应蛋白(CRP)与降钙素原(PCT)在感染性心内膜炎(IE)患者中的变化及临床意义。方法回顾性分析2010年1月-2012年12月确诊的16例感染性心内膜炎患者纳入观察组,16名健康志愿者纳入对照组,观察比较两组研究对象CRP、PCT水平,并对比较CRP与PCT对IE的早期诊断性能;采用SPSS17.0软件进行统计分析。结果 16例IE患者送检标本检出链球菌属9株、葡萄球菌属4株、肠球菌属3株;观察组患者CRP、PCT水平分别为(31.51±3.84)mg/L、(7.21±0.22)ng/ml均明显高于对照组的(6.79±4.57)mg/l、(0.15±0.14)ng/ml,差异有统计学意义(P<0.05);CRP与PCT诊断IE敏感度分别为87.50%与93.75%,两者比较差异无统计学意义,但是PCT具有更高的特异度为93.75%,明显高于对照组的68.75%,差异有统计学意义(P<0.05)。结论血清PCT对早期诊断IE具有较高的敏感度和特异度,其诊断价值高于CRP,是IE早期诊断的一项重要指标。OBJECTIVE To explore the clinical significance of changes of serum C-reactive protein （CRP） and pro- ealcitonin （PCT） in the patients with infective endocarditis （IE）. METHODS A total of 16 patients with confirmed IE who were treated in the hospital from Jan 2010 to Dec 2012 were assigned as the observation group, meanwhile 16 healthy people were set as the control group, then the levels of CRP and PCT were observed and compared be- tween the two groups, the performance in early diagnosis of IE was compared between CRP and PCT, and the sta- tistical analysis was performed with the use of SPSS17.0 software. RESULTS Totally 9 strains of Streptococcus spp, 4 strains of Staphylococcus spp, and 3 strains of Enterococcus spp have been isolated from the 16 patients with IE. The CRP level of the observation group was（31.51±3.84）mg/L, significantly higher than 6.79±4.57） mg/L of the control group; the PCT level of the observation group was（7.21±0.22）ng/mL, significantly higher than （0.15±0.14）ng/ml of the control group （P〈0.05）. The sensitivity of the CRP in diagnosis of IE was 87. 50%, the PCT 93.75%, without statistical significance;however, the specificity of the PCT in diagnosis of IE was 93.75%, significantly higher than 68.75% of the control group （P〈0.05）. CONCLUSION The serum PCT has higher sensitivity and specificity in early diagnosis of IE than the CRP, and it is an important indicator for the early diagnosis of IE.

关 键 词：C-反应蛋白 降钙素原 感染性心内膜炎 敏感度 特异度 

分 类 号：R446[医药卫生—诊断学]