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目的:探究血清降钙素原(PCT)、C反应蛋白(CRP)及内毒素在细菌性血流感染所致脓毒症患者中的早期诊断价值。方法:回顾性分析2010年5月~2015年5月期间我院收治确诊的细菌性血流感染所致脓毒症患者123例,测定其血清PCT、CRP及内毒素水平,通过受试者工作特征曲线(ROC)曲线探究三者对细菌性血流感染所致脓毒症的诊断价值。结果:血样培养结果显示,123例细菌性血流感染所致脓毒症患者中存在感染G+菌35例,感染G-菌88例;G+菌组的血清PCT、CRP及内毒素水平明显低于G-菌组(P<0.05);且G+菌组、G-菌组及所有细菌组患者三指标两两间均呈正相关关系(P<0.05);ROC曲线显示,血清PCT、CRP和内毒素预测G+菌血流感染所致脓毒症患者的临界值分别为1.58μg/L、95.25 mg/L与16.71 ng/L,其灵敏度和特异度别为(65.92%,88.37%)、(67.39%,84.38%)与(56.34%,78.93%),预测G-菌血流感染所致脓毒症患者的临界值分别为2.45μg/L、79.45mg/L与15.54 ng/L,其灵敏度和特异度别为(78.73%,97.13%)、(68.89%,92.38%)与(65.39%,95.33%)。结论:检测血清PCT、CRP、内毒素水平有利于鉴别G-菌和G+菌血流感染所致脓毒症患者,且敏感度、特异度均较高,可用于早期诊断细菌性血流感染所致脓毒症。
Objective: To investigate the early diagnostic value of serum procalcitonin (PCT), C-reactive protein (CRP) and endotoxin in patients with sepsis caused by bacterial bloodstream infection. Methods: A retrospective analysis of 123 cases of sepsis caused by bacterial bloodstream infection confirmed in our hospital from May 2010 to May 2015 was performed. The serum PCT, CRP and endotoxin levels were measured. Characteristic Curve (ROC) Curves Explore the diagnostic value of the three in sepsis caused by bacterial bloodstream infection. Results: The results of blood culture showed that 35 cases of G + bacteria and 88 cases of G-bacteria were found in 123 cases of sepsis caused by bacterial bloodstream infection. The levels of serum PCT, CRP and endotoxin in G + group were significantly lower than those in G + group (P <0.05). There was a positive correlation between the three indexes in G + group, G - bacteria group and all bacteria groups (P <0.05). The ROC curve showed that serum PCT, CRP and endotoxin The sensitivity and specificity of the patients with sepsis caused by G + infection were 1.58μg / L, 95.25 mg / L and 16.71 ng / L respectively, with the sensitivity and specificity of (65.92%, 88.37%) and (67.39% , 84.38%) and (56.34%, 78.93%). The cutoff values of sepsis caused by G-bacteria bloodstream infection were 2.45μg / L, 79.45mg / L and 15.54ng / L, respectively. The sensitivity and specificity The scores were (78.73%, 97.13%), (68.89%, 92.38%) and (65.39%, 95.33%) respectively. Conclusion: The detection of serum PCT, CRP and endotoxin levels is helpful to identify the patients with sepsis caused by bloodstream infections of G- and G + bacteria, with high sensitivity and specificity, which can be used for early diagnosis of bacterial bloodstream infections Cause sepsis.