三项血清学检查联合应用对老年菌血症早期诊断的价值
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摘要
目的 探讨C-反应蛋白(CRP)、降钙素原(PCT)和血清样淀粉蛋白A(SAA)对于老年菌血症早期诊断的价值。方法 选择2016年12月至2018年11月我院收治的老年感染患者140例(年龄≥65岁)为研究对象,按血培养结果分为菌血症患者(60例)和非菌血症患者(80例);选择同期健康体检者60例(年龄≥65岁)为对照组,测定全部研究对象血清CRP、PCT和SAA水平及阳性率。结果 与对照组比较,菌血症和非菌血症患者血清CRP、PCT和SAA水平均显著升高(P<0.05);且菌血症患者这3项指标水平高于非菌血症者(P<0.05)。在单项检测中,PCT的敏感性和特异性最高。3项联合检测的诊断价值高于单项检测。由G~-菌引起的菌血症患者这3项指标水平高于G~+菌菌血症患者(P<0.05)。结论 血清CRP、PCT和SAA这3项指标对老年菌血症的早期诊断具有一定价值。
Objective To explore the diagnostic value of C-reactive protein(CRP), procalcitonin(PCT) and serum amyloid A(SAA) in early diagnosis of senile bacteriosis. Methods 140 infected patients(age≥65)who were treated in our hospital from December 2016 to November 2018 were enrolled. According to the results of blood culture, they were divided into bacteremia group(60 cases) or non-bacteremia group(80 cases). Sixty healthy person(age≥65) were selected as the control group. Serum levels of CRP, PCT and SAA and positive rates were determined. Results The levels of CRP, PCT and SAA in bacteremia and non-bacteremia groups were higher than those in control group respectively(P<0.05), and the three indexes were higher in bacteremia group than in non-bacteremia group. The sensitivity and specificity of PCT were the highest in the single test. The diagnostic value of combined test of the three indexes was higher than those of the single test. The levels of these three indicators in patients with G~- bacterium-associated bacteremia were higher than those in patients with G~+ bacterium-associated bacteremia(P<0.05). Conclusion The serum levels of CRP, PCT and SAA have certain value in early diagnosis of senile bacteremia.
Objective To explore the diagnostic value of C-reactive protein(CRP), procalcitonin(PCT) and serum amyloid A(SAA) in early diagnosis of senile bacteriosis. Methods 140 infected patients(age≥65)who were treated in our hospital from December 2016 to November 2018 were enrolled. According to the results of blood culture, they were divided into bacteremia group(60 cases) or non-bacteremia group(80 cases). Sixty healthy person(age≥65) were selected as the control group. Serum levels of CRP, PCT and SAA and positive rates were determined. Results The levels of CRP, PCT and SAA in bacteremia and non-bacteremia groups were higher than those in control group respectively(P<0.05), and the three indexes were higher in bacteremia group than in non-bacteremia group. The sensitivity and specificity of PCT were the highest in the single test. The diagnostic value of combined test of the three indexes was higher than those of the single test. The levels of these three indicators in patients with G~- bacterium-associated bacteremia were higher than those in patients with G~+ bacterium-associated bacteremia(P<0.05). Conclusion The serum levels of CRP, PCT and SAA have certain value in early diagnosis of senile bacteremia.
引文
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[9] GAO Yuping,ZHAO Zhengjun,PANG Shuhua.Comparative analysis of serum calcitonin and blood culture results in patients with sepsis in intensive care unit[J].J Clin Med Pract,2016,20(19):197-198.(in Chinese) 高郁平,赵正军,庞树华.重症监护病房脓毒血症患者血清降钙素与血培养结果比较分析[J].实用临床医药杂志,2016,20(19):197-198.
[10] Oksuz L,Somer A,Salman N,et al.Procalcitonin and C-reactive protein in differantiating to contamination from bacteremia[J].Braz J Microbiol,2014,45(4):1415-1421.
[11] Hoeboer SH,Groeneveld AB.Changes in circulating procalcitious disease in febrile,critically ill patients[J].PLoS One,2013,8(6):654-656.
[12] LI Liuhua.Clinical value of combined detection of SAA and CRP in the differentiation of infectious diseases in children[J].Chin J Clin Lab Sci(Electr),2018,7(1):113-114.(in Chinese) 李留花.小儿感染性疾病鉴别断中SAA和CRP联合检测的临床价值[J].临床检验杂志(电子版),2018,7(1):113-114.
[2] David van Duin.Diagnostic challenges and opportunities in older adults with diseases[J].Clin Infect Dis,2012,54(7):973-978.
[3] WANG Yunduo.The impact of population aging on public pension system[J].Inner Mongolia Social Sci(Chin Vers),2017,38(5):166-172.(in Chinese) 王云多.人口老龄化对公共养老金制度的影响[J].内蒙古社会科学(汉文版),2017,38(5):166-172.
[4] Shivakoti R,Yang WT,Gupte N,et al.Concurrent anemia and elevated CRP predicts HIV clinical treatment failure,including TB,post-antiretroviral therapy initiation[J].Clin Infect Dis,2015,4827(2):1195-1205.
[5] SUN Fang.Diagnostic value of serum amyloid A and C reactive protein in children with hand,foot and mouth disease[J].Chin Foreign Med Treat,2017,36(30):193-195.(in Chinese) 孙芳.血清淀粉样蛋白A联合C反应蛋白检测在手足口病患儿中的诊断价值[J].中外医疗,2017,36(30):193-195.
[6] NIU Caihong.Early diagnostic significance of SAA hs-CRP CRP detection for infectious diseases in children[J].Pub Med Forum Magaz,2017,21(14):1824-1825.(in Chinese) 牛彩红.小儿感染性疾病SAA hs-CRP CRP检测的早期诊断意义[J].基层医学论坛,2017,21(14),1824-1825.
[7] WANG Qiaolan,CHEN Jieqiong,YU Pengfei.Application of quantitative detection of serum procalcitonin in early diagnosis of bacteremia in the elderly[J].J Pract Med Techn,2016,23(2):176-177.(in Chinese) 王巧兰,陈洁琼,于鹏飞.血清降钙素原定量检测在老年人菌血症早期诊断的应用[J].实用医技杂志,2016,23(2):176-177.
[8] LI Yuanhua,SONG Xiuzhao,QI Yingjing,et al.Application value of plasma calcitonin concentration determination in sepsis [J].J Clin Med Pract,2014,18(15):155-157.(in Chinese) 李远华,宋秀婵,戚应静,等.血浆降钙素浓度水平测定在脓毒血症中的应用价值[J].实用临床医药杂志,2014,18(15):155-157.
[9] GAO Yuping,ZHAO Zhengjun,PANG Shuhua.Comparative analysis of serum calcitonin and blood culture results in patients with sepsis in intensive care unit[J].J Clin Med Pract,2016,20(19):197-198.(in Chinese) 高郁平,赵正军,庞树华.重症监护病房脓毒血症患者血清降钙素与血培养结果比较分析[J].实用临床医药杂志,2016,20(19):197-198.
[10] Oksuz L,Somer A,Salman N,et al.Procalcitonin and C-reactive protein in differantiating to contamination from bacteremia[J].Braz J Microbiol,2014,45(4):1415-1421.
[11] Hoeboer SH,Groeneveld AB.Changes in circulating procalcitious disease in febrile,critically ill patients[J].PLoS One,2013,8(6):654-656.
[12] LI Liuhua.Clinical value of combined detection of SAA and CRP in the differentiation of infectious diseases in children[J].Chin J Clin Lab Sci(Electr),2018,7(1):113-114.(in Chinese) 李留花.小儿感染性疾病鉴别断中SAA和CRP联合检测的临床价值[J].临床检验杂志(电子版),2018,7(1):113-114.