白细胞介素-6和降钙素原在细菌性血流感染疾病诊断中的应用价值  

Application values of interleukin-6 and procalcitonin in diagnosis of bacterial bloodstream infectious diseases

作　　者：任然[1] 张灵玲[1] Ren Ran;Zhang Lingling(Department of Laboratory,Affiliated Hospital of Chengdu University of Traditional Chinese Medicine,Chengdu 610072,Sichuan,China)

机构地区：[1]成都中医药大学附属医院检验科

出　　处：《实用检验医师杂志》2019年第3期165-168,共4页Chinese Journal of Clinical Pathologist

摘　　要：目的探讨各炎症指标对细菌性血流感染疾病的诊断价值以及在不同革兰染色细菌感染鉴别诊断中的价值。方法选择2018年1—6月在成都中医药大学附属医院住院且诊断为细菌性血流感染的90例患者作为细菌感染组,根据细菌革兰染色结果进一步将细菌感染组分为革兰阳性(G^+)菌感染组和革兰阴性(G^-)菌感染组。另选本院50例健康体检者作为健康对照组。分别检测白细胞介素-6(IL-6)、降钙素原(PCT)、C-反应蛋白(CRP)、白细胞计数(WBC)、中性粒细胞比例(NEU)、中性粒细胞平均体积(MNV)、中性粒细胞平均传导率(MNC)和中性粒细胞平均散射值(MNS)等炎症指标,统计各炎症指标在两组中的表达情况。绘制受试者工作特征曲线(ROC),分析各炎症指标对细菌性血流感染的诊断价值以及对不同革兰染色细菌感染的鉴别诊断价值。结果细菌感染组的IL-6、PCT、CRP、WBC、NEU、MNV和MNS均明显高于健康对照组〔IL-6(ng/L):321.65(726.03,104.05)比6.80(15.08,5.60),PCT(ng/L):0.93(9.30,0.22)比0.03(0.04,0.02),CRP(mg/L):87.00(149.00,46.00)比1.50(2.75,1.00),WBC(×10^9/L):8.80(12.20,6.70)比5.70(8.00,4.60),NEU(%):86.00(91.00,79.00)比62.00(69.70,59.00),MNV:167.90(187.10,151.55)比140.70(148.90,137.40),MNS:157.6(158.7,155.5)比122.0(139.9,117.1),均P<0.05〕。G-菌感染组的IL-6、PCT、CRP和NEU明显高于G+菌感染组〔IL-6(ng/L):375.50(717.80,240.00)比115.80(551.90,70.60),PCT(ng/L):1.61(16.71,-0.43)比0.35(1.74,0.15),CRP(mg/L):101.00(158.00,66.00)比55.00(102.00,26.00),NEU(%):88.00(91.25,80.00)比83.00(88.50,76.50),均P<0.05〕;两组的其余炎症指标比较差异均无统计学意义(均P>0.05)。PCT对细菌感染性疾病的诊断价值最高,其次为IL-6,两者的ROC曲线下面积(AUC)分别为0.996〔95%可信区间(95%CI)=0.980~1.000〕、0.988(95%CI=0.972~1.000);CRP对G^-菌感染的诊断价值最高,其次为PCT,两者的AUC分别为0.683(95%CI=0.571~0.772)、0.667(95%CI=0.579~0.778)。结论IL-6�Objective To investigate the value of each one of inflammatory indexes in diagnosis of bacterial bloodstream infections and in differential diagnosis of bacterial infections with different Gram staining results.Methods Ninety patients(48 males and 42 females)were hospitalized in the Affiliated Hospital of Chengdu University of Traditional Chinese Medicine and diagnosed as bacterial bloodstream infections from January to June 2018 and they were assigned in the bacterial infection group;according to the results of Gram staining of the blood bacterial infection group was further subdivided into two subgroups,Gram-positive(G^+)bacteria and Gram-negative(G^-)bacteria,and another 50 healthy subjects(25 males and 25 females)served as a healthy control group.Simultaneously the inflammatory indexes such as interleukin-6(IL-6),procalcitonin(PCT),C-reactive protein-α(CRP),white blood cell count(WBC),neutrophile percentage(NEU),mean neutrophile volume(MNV),mean neutrophile conductivity(MNC),mean neutrophile scattering value(MNS),etc were detected in various groups,and the expression situations of inflammatory indexes in the two groups were recorded and statistically analyzed.The receiver operating characteristic(ROC)curve was drawn to evaluate the diagnostic value of each inflammatory index for the bacterial blood stream infection and the differential diagnosis value for different Gram staining bacterial infections.Results Compared with the control group,the levels of IL-6,PCT,CRP,WBC,NEU,MNV and MNS in bacterial bloodstream infection group were obviously higher in the bacterial infection group,the differences being statistically significant[IL-6(ng/L):321.65(726.03,104.05)vs.6.80(15.08,5.60),PCT(ng/L):0.93(9.30,0.22)vs.0.03(0.04,0.02),CRP(mg/L):87.00(149.00,46.00)vs.1.50(2.75,1.00),WBC(×10^9/L):8.80(12.20,6.70)vs.5.70(8.00,4.60),NEU(%):86.00(91.00,79.00)vs.62.0(69.7,59.0),MNV:167.90(187.10,151.55)vs.140.70(148.90,137.40),MNS:157.6(158.7,155.5)vs.122.0(139.9,117.1),all P<0.05];the levels of IL-6,PCT,CRP and NEU in G^- bact

关 键 词：白细胞介素-6 降钙素原 炎症指标 细菌性血流感染 

分 类 号：R44[医药卫生—诊断学]