IL-6、SAA、CRP及PCT联合检测对肺炎支原体合并细菌感染患者的早期诊断价值  

Early diagnostic value of combined detection of IL-6,SAA,CRP,and PCT in patients with Mycoplasma pneumoniae complicated with bacterial infection

作　　者：谭罗坤 罗嫚妮 谢桂梅 李秀珍[1] TAN Luo-kun;LUO Man-ni;XIE Gui-mei(Department of Clinical Laboratory,Huaiji County People's Hospital,Zhaoqing 526400,China)

机构地区：[1]广东省怀集县人民医院检验科,526400

出　　处：《中国现代药物应用》2024年第8期66-69,共4页Chinese Journal of Modern Drug Application

摘　　要：目的探讨白细胞介素-6(IL-6)、血清淀粉样蛋白A(SAA)、C反应蛋白(CRP)及血清降钙素原(PCT)联合检测对肺炎支原体合并细菌感染患者的早期诊断价值。方法选取疑似合并细菌感染的肺炎支原体患者150例,根据血培养结果分为观察组(确诊为肺炎支原体合并细菌感染,85例)和对照组(单纯肺炎支原体感染,65例)。收集所有患者血培养当天的血清标本,检测血清中的IL-6、SAA、CRP及PCT水平。比较两组患者IL-6、SAA、CRP及PCT水平,分析四项指标对肺炎支原体合并细菌感染的诊断效能,分析四项指标联合诊断肺炎支原体合并细菌感染的价值。结果观察组患者血清IL-6、SAA、CRP及PCT分别为(238.57±21.57)pg/ml、(169.68±17.66)mg/L、(77.98±6.58)mg/L、(13.58±2.04)ng/ml,均高于对照组的(137.25±18.07)pg/ml、(128.90±15.71)mg/L、(52.60±5.87)mg/L、(8.24±1.87)ng/ml,,差异有统计学意义(P<0.05)。IL-6的诊断特异性、敏感性、约登指数、阴性预测值、阳性预测值分别为92.31%、83.53%、0.7584、81.08%、93.42%,SAA的分别为83.08%、74.12%、0.5720、71.05%、85.14%,CRP的分别为86.15%、90.59%、0.7674、87.50%、89.53%,PCT的分别为70.77%、71.76%、0.4253、65.71%、76.25%;CRP的约登指数最高,PCT的约登指数最低。串联检测的诊断特异性、敏感性、约登指数、阴性预测值、阳性预测值分别为70.77%、71.76%、0.4253、65.71%、76.25%,并联检测的分别为92.31%、94.12%、0.8643、92.31%、94.12%,并联检测的约登指数高于串联检测。结论与单纯肺炎支原体感染患者相比,肺炎支原体合并细菌感染患者的血清IL-6、SAA、CRP及PCT水平有升高趋势。联合检测四项指标有助于早期诊断肺炎支原体合并细菌感染,对于减少漏诊、帮助医务人员制定正确的治疗方案具有意义。Objective To explore the early diagnostic value of combined detection of interleukin-6(IL-6),serum amyloid A(SAA),C-reactive protein(CRP),and procalcitonin(PCT)in patients with Mycoplasma pneumoniae complicated with bacterial infection.Methods 150 cases of Mycoplasma pneumoniae with suspected bacterial infection were selected.Based on blood culture results,patients with Mycoplasma pneumoniae complicated with bacterial infection were included in the observation group(85 cases),while patients with Mycoplasma pneumoniae infection were included in the control group(65 cases).The serum samples from patients on the day of blood culture were collected for future testing of levels of IL-6,SAA,CRP,and PCT.The levels of IL-6,SAA,CRP and PCT were compared between the two groups,and the diagnostic efficiency of the four indicators in the diagnosis of Mycoplasma pneumoniae with bacterial infection was analyzed,and the value of the four indicators in the combined diagnosis of Mycoplasma pneumoniae with bacterial infection was analyzed.Results Serum IL-6,SAA,CRP and PCT in the observation group were(238.57±21.57)pg/ml,(169.68±17.66)mg/L,(77.98±6.58)mg/L,and(13.58±2.04)ng/ml,which were higher than(137.25±18.07)pg/ml,(128.90±15.71)mg/L,(52.60±5.87)mg/L,and(8.24±1.87)ng/ml in the control group,and the difference was statistically significant(P<0.05).The diagnostic specificity,sensitivity,Youden's index,negative predictive value and positive predictive value of IL-6 were 92.31%,83.53%,0.7584,81.08%and 93.42%,those of SAA were 83.08%,74.12%,0.5720,71.05%and 85.14%,those of CRP were 86.15%,90.59%,0.7674,87.50%and 89.53%,those of PCT were 70.77%,71.76%,0.4253,65.71%and 76.25%.CRP had the highest Yoden's index and PCT had the lowest Yoden's index.The diagnostic specificity,sensitivity,Jordon index,negative predictive value,positive predictive value were 70.77%,71.76%,0.4253,65.71%,76.25%for series detection,and 92.31%,94.12%,0.8643,92.31%,94.12%for parallel detection.The Youden's index of parallel detection was higher than that

关 键 词：肺炎支原体 细菌感染 联合检测 白细胞介素-6 血清淀粉样蛋白A C反应蛋白 血清降钙素原 

分 类 号：R563.1[医药卫生—呼吸系统]