IL-6,IL-10与PCT,CRP在呼吸科血流感染早期诊断中的对比研究  

Comparative Study of IL-6,IL-10 to PCT and CRP in The Early Diagnosis of Bloodstream Infection in Respiratory Depart-ment

作　　者：顾国忠[1] 王春媛[1] 朱英娟 王培培 侯衍修[1] 周艳[1] 任慧 宋振明 杨晓晶[1] GU Guo-zhong;WANG Chun-yuan;ZHU Ying-juan(Dqing First Hospital Department of Respiration,Daqing163001,China)

机构地区：[1]大庆油田总医院(大庆市第一医院)呼吸科,黑龙江大庆163001

出　　处：《中国实验诊断学》2022年第7期976-980,共5页Chinese Journal of Laboratory Diagnosis

基　　金：本研究为黑龙江省卫健委科研题目(2020-012)。

摘　　要：目的 比较IL-6,IL-10与PCT,CRP在血流感染细菌类型及预后判断的诊断价值。方法 将2019年11月至2020年11月大庆油田总医院呼吸科确诊血流感染的病例总共76例分为革兰阳性菌组(G+组)、革兰阴性菌组(G-组),第一时间采血检测CRP、PCT、IL-6、IL-10、血常规,根据血流感染患者细菌类型,判断上述炎症指标数值与细菌感染类型的相关性。结果 ①CRP、白细胞计数、IL-6、IL-10对诊断血流感染细菌类型无明显差异(P>0.05),降钙素原、中性粒百分比在G^(-)、G^(+)组中存在显著差异(P<0.05),IL-6在血流感染的诊断价值上高于IL-10(P<0.05)。②血流感染中上述炎症指标的高低程度并不能作为疾病预后的判定指标(P>0.05),而年龄与疾病严重程度相关联。③降钙素原及中性粒百分比在鉴别血流感染细菌类型中的cut-off值为2.84ng/ml和90.85%,其诊断血流感染的敏感性分别为73%、56.8%,特异性分别为71.8%、89.7%。结论 降钙素原对血流感染的诊断有较高的敏感性及特异性,且对血流感染细菌类型方面具有指导价值。IL-6在血流感染的诊断价值上高于IL-10,二者显著升高提示病人预后差,而其他炎症指标显著升高提示可能存在血流感染,并不能直接区分细菌类型。建议临床医生根据患者的实际情况选择合适的炎症指标指导治疗、减少检查费用。Objective To compare the diagnostic value of IL-6,IL-10 and PCT,and CRP in the type of bloodstream infected bacteria and the prognostic judgment.Methods A total of 76 cases of confirmed blood stream infection in the respiratory department from November 2019 to November 2020 were divided into the Gram-positive bacteria group(G^(+)Group),the Gram-negative bacteria group(G^(-)Group),immediately blood samples for CRP were collected,PCT,IL-6,IL-10 and blood routine,and the correlation between the value of the inflammation index was determined according to the bacterial type of blood stream infection patients.Results①CRP,WBC,IL-6 and IL-10 showed no different types of blood infected bacteria(P>0.05),and the percentage of neutrophils and PCT were significant differences in the groups(P<0.05),while IL-6 had a higher diagnostic value for blood stream infection than IL-10(P<0.05).②The degree of inflammation in BSI can not be used as an indicator of disease prognosis(P>0.05),and age is associated with disease severity.③The cut-off values of PCT and neutrophil percentage in the differential blood stream infected bacterial types were 2.84ng/ml and 90.85%,and the sensitivity of diagnostic blood flow infection was 73% and 56.8%,and the specificity was 71.8% and 89.7%.Conclusion PCT has a high sensitivity and specificity to the diagnosis of blood flow infection,and has a guiding value for the bacterial type of blood flow infection.IL-6 has a higher diagnostic value than IL-10 in blood flow infection,with a significant increase in both suggesting poor patient prognosis,while other significantly elevated inflammatory indicators suggested the possibility of blood flow infection and could not directly distinguish between bacterial types.Clinicians are recommended that they choose appropriate inflammatory indicators according to the actual situation of patients to guide the treatment and reduce the cost of examination.

关 键 词：降钙素原 白介素6 白介素10 白细胞 血流感染 

分 类 号：R446.6[医药卫生—诊断学]