血清C反应蛋白、降钙素原水平对脓毒症的诊断价值

    Diagnostic value of serum C-reactive protein and procalcitonin on sepsis

    • 摘要: 目的:探讨C反应蛋白(CRP)、降钙素原(PCT)诊断危重患者脓毒症的临床诊断价值。方法:选择ICU危重患者64例,根据1991年美国胸科医师学院/美国危重病医学会共识会议制定的脓毒症诊断标准分为脓毒症组50例,非脓毒症组14例,另选同期健康人22名为对照组。固相免疫层析法半定量测定PCT水平,定量免疫速率比浊法测定CRP水平,观察各指标诊断危重患者脓毒症的敏感性、特异性、阳性预测值、阴性预测值及Youden指数。以灵敏度为纵坐标,1-特异度为横坐标,分析ROC曲线,并确定检测的最佳阈值。结果:PCT的敏感性、特异性、阳性预测值、阴性预测值和Youden指数及ROC曲线下的面积值均优于CRP。而PCT联合CRP诊断的敏感性和准确率优于各指标独立诊断。结论:PCT对脓毒症有很好的临床诊断价值,联合PCT及CRP诊断脓毒症可以提高诊断的敏感性和准确率。

       

      Abstract: Objective:To investigate the diagnostic significance of C-reactive protein (CRP) and procalcitonin (PCT) on sepsis. Methods:According to the criterion of sepsis compiled by America College of Chest Physicians/America Society of Critic Care Medicine in 1991. Sixty-four severe patients were selected in ICU. The patients were divided into two groups:sepsis group(n=50) and none sepsis group(n=14),the baseline clinical data of two groups were comparable. PCT and CRP were measured by double-antibody sandwich ELISA method, solid-phase semi-quantitative immunochromatography and quantitative immunization rate turbidimetry, the sensitivity,specificity,positive predictive value,negative predictive value,Youdens' index of two biomarkers were calculated. The ROC was described for further analysis. Results:The sensitivity, specificity, positive predictive value, negative predictive value, Youdens' index and the area under the curve of ROC of PCT were better than those of CRP. And the combination of two biomarkers had higher sensitivity than that of CRP or PCT separately. Conclusions:PCT has a relatively good diagnostic significance on sepsis. The combination of multibiomarkers should be considered to apply in order to increase the sensitivity of dignosis for sepsis.

       

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