血清降钙素原与C-反应蛋白及血常规检测诊断尿源性脓毒血症的评价  

Evaluation of combined detection of serum PCT and CRP and blood routine for diagnosis of urogenous sepsis

作　　者：姚远[1] 王伟[1] 周毅[1] 杨剑文[1] 卢启海[1] 

机构地区：[1]柳州市人民医院泌尿外科,广西柳州545001

出　　处：《中华医院感染学杂志》2015年第20期4659-4661,共3页Chinese Journal of Nosocomiology

基　　金：广西壮族自治区卫生厅基金资助项目(2011J0302029)

摘　　要：目的探讨联合检测血清降钙素原(PCT)、C-反应蛋白(CRP)及血常规在诊断脓毒血症,鉴别尿源性脓毒血症与非尿源性脓毒血症的价值,以指导临床诊治疾病。方法 2013年10月-2014年10月纳入50例尿源性脓毒血症患者(A组)、100例非尿源性脓毒血症患者(B组)、100例常规泌尿系统感染患者(C组)为研究对象,检测其血清PCT、CRP、白细胞(WBC)计数,对比3组患者各项指标的差异。结果 A、B组患者PCT分别为(3.18±1.25)、(3.35±1.48)μg/L,差异无统计学意义,但CRP分别为(18.04±8.01)、(77.42±33.51)mg/L,WBC分别为(13.71±5.68)、(17.41±3.58)×109/L,A组均明显低于B组,差异有统计学意义(P<0.05);A组患者PCT、CRP及WBC均明显高于C组,且ROC曲线指出3种指标均有助于诊断尿源性脓毒血症(P<0.05),但PCT的曲线下面积高于其他两项。结论单独检测PCT、CRP及血常规,均有助于早期诊断尿源性脓毒血症,但PCT的诊断效能最高;PCT难以区分尿源性脓毒血症及非尿源性脓毒血症,需要CRP及血常规提供辅助分析信息;联合检测血清PCT、CRP及血常规对诊断脓毒血症、明确病源部位有积极意义。OBJECTIVE To explore the significance of the combined detection of serum calcitonin （PCT） and C‐re‐active protein （CRP） and blood routine in the diagnosis of sepsis and identify urogenous sepsis and non‐urogenous sepsis in order to guide the clinical diagnosis and treatment of the disease .METHODS Totally 50 patients with u‐rogenous sepsis （group A） ,100 cases of non‐urogenous sepsis （group B） and 100 patients with ordinary urinary tract infection （group C） during Oct .2013 to Oct .2014 were enrolled as the research subjects .The serum PCT , CRP ,WBC （WBC） counts were detected and compared .RESULTS PCT was respectively （3 .18 ± 1 .25）μg/L and （3 .35 ± 1 .48）μg/L for group A and group B ,the difference was not significant ,however ,CRP was respectively （18 .04 ± 8 .01） mg/L and （77 .42 ± 33 .51） mg/L and WBC was respectively （13 .71 ± 5 .68） × 109/L and （17 .41 ± 3 .58）× 109/L ,indicating these indexes in group A were significantly lower than in group B（P〈0 .05） .PCT , CRP and WBC were significantly higher in group A than in group C ,and the ROC curve showed that the three in‐dexes were helpful in the diagnosis of urogenous sepsis （P〈0 .05） ,but the area under the curve for PCT was higher than for the other two .CONCLUSION Detection of PCT ,CRP and blood routine alone all helps to early di‐agnosis of urogenous sepsis ,and the diagnosis by PCT has the highest efficiency .PCT is difficult to distinguish u‐rogenous sepsis and non‐urogenous sepsis ,which calls for CRP and blood routine to provide auxiliary information . Combined detection of serum PCT and CRP and blood routine has a positive significance for diagnosis of sepsis and clarify source sites of the disease .

关 键 词：尿源性脓毒血症 降钙素原 C-反应蛋白 白细胞计数 诊断 

分 类 号：R446[医药卫生—诊断学]