摘要
目的评价血清降钙素原(PCT)联合C反应蛋白(CRP)检测在血流感染早期临床诊断的价值。方法检测156例血流感染阳性患者的PCT、CRP、白细胞(WBC)计数和红细胞沉降率(ESR)结果,并以105例血流感染阴性患者为对照组,以SPSS19.0软件进行受试者工作特性(ROC)曲线分析,计算曲线下面积(AUC),获得最佳诊断点。计算PCT联合CRP在诊断血流感染中的敏感性和特异性。结果 PCT、CRP、WBC和ESR的AUC分别为0.890、0.714、0.712和0.545;ROC曲线诊断标准选择为0.307处的约登指数最大,敏感性为67.6%,特异性为88.6%,阳性预测值为82.1%,阴性预测值为78.0%,阳性似然比为5.93,阴性似然比为0.37,一致率为79.5%,Kappa值为57.4%;当PCT的Cut-off值为0.307 ng/mL时血流感染阳性组和阴性组之间差异有统计学意义(χ2=52.807,P<0.001);PCT并联CRP检测的诊断敏感性为91.1%,特异性为51.7%;PCT串联CRP检测的诊断敏感性为55.5%,特异性为96.6%。结论 PCT检测可用于血流感染的早期临床诊断,PCT联合CRP检测能提高诊断的敏感性和特异性。
Objective To evaluate the signification of procalcitonin （PCT） combined C reactive protein （CRP） detection in the early diagnosis of bloodstream infection. Methods PCT, CRP, white blood cell （ WBC ） count and erythrocyte sedimentation rate （ESR） were determined in 156 patients with bloodstream infection, and 105 patients with negative bloodstream infection were as controls. The receiver operating characteristic （ROC） curve was analyzed for PCT, CRP,WBC count and ESR by SPSS 19.0 software. The optimal values were obtained by calculating the area under ROC eurve（AUC）. The sensitivity and specificity of PCT combined CRP detection in the diagnosis of bloodstream infection were calculated. Results The AUC of PCT, CRP, WBC count and ESR were 0. 890,0. 714,0. 712 and 0. 545, respectively. The diagnosis criteria at 0. 307 of the ROC curve resulted in the greatest Youden index with the sensitivity of 67.6% and the specificity of 88.6%. The positive and negative predictive values were 82. 1% and 78.0%, and the positive and negative likelihood ratio were 5.93 and 0. 37. The concordance rate was 79.5% , and Kappa value was 57.4%. When the cut-off value was 0.307 ng/mL, there were statistical significances between the 2 groups（x^2 =52.807, P 〈 0.001 ）. The sensitivity of 91.1% and the specificity of 51.7% were in parallel detection of PCT and CRP, and the sensitivity of 55.5% and the specificity of 96.6% were in serial detection. Conclusions PCT is a valuable predictor for the early diagnosis of bloodstream infection. PCT combined CRP detection could improve the sensitivity and specificity.
出处
《检验医学》
CAS
2013年第8期662-665,共4页
Laboratory Medicine
关键词
降钙素原
C反应蛋白
血流感染
Procalcitonin
C reactive protein
Bloodstream infection
