检验医学与临床2024，Vol.21Issue(1)：11-15,5.DOI:10.3969/j.issn.1672-9455.2024.01.003
血清PCT、CRP联合NLR在细菌性血流感染中的应用价值
Application value of serum PCT,CRP combined with NLR in bacterial bloodstream infection
摘要
Abstract
Objective To explore the application value of serum procalcitonin(PCT),C-reactive protein(CRP)combined with neutrophil/lymphocyte ratio(NLR)in the early diagnosis and differential diagnosis of bacterial bloodstream infection(BSI).Methods A total of 339 patients diagnosed as bacterial BSI in the Affil-iated Zhongshan Hospital,Fudan University from January to December 2022 served as the blood culture posi-tive group,while 185 patients clinically diagnosed as fever and with the blood culture negative admitted and treated in this hospital during the same period were selected as the blood culture negative group.The patients were divided into the Gram negative bacterial infection group(GN-BSI,194 cases)and Gram positive bacterial infection group(GP-BSI,145 cases).The GN-BS1 group was divided into the three subgroups of Enterobacte-riales subgroup(133 cases),non-fermentative bacterial subgroup(49 cases)and the other bacterial subgroup(12 cases).The differences of serum PCT,CRP and NLR levels were compared among different groups.The receiver operating characteristic(ROC)curve was used and the area under the curve(AUC),sensitivity and specificity were calculated.The diagnostic efficiency of serum PCT,CRP and NLR alone and in combination for bacterial BIS was assessed.Results The serum PCT,CRP and NLR levels in the blood culture positive group were higher than those in the blood culture negative group,and the difference was statistically signifi-cant(P＜0.05);the PCT median level in the GN-BSI group was 1.77 ng/mL,which was higher than 0.79 ng/mL in the GP-BSI group,and the difference was statistically significant(P＜0.05).The serum PCT and CRP levels in the Enterobacteriales subgroup were higher than those in the non-fermentative bacterial sub-group,and the difference was statistically significant(P＜0.05).In diagnosing bacterial BSI,the area under the curve(AUC)of the 3-indicator combined was 0.866,the sensitivity was 0.752 and the specificity was 0.816;in the differentiation diagnosis of GN-BSI and GP-BSI,AUC of the 3-indicator combined was 0.977,the sensitivity was 0.959,specificity was 0.917;in the differentiation diagnosis of Enterobacteriales BSI and and non-fermentative bacterial BSI,AUC of the 3-indicator combined was 0.842,the sensitivity was 0.699,the spe-cificity was 0.857,which all were higher than the diagnostic value of single indicator detection.Conclusion Serum PCT,CRP and NLR have certain clinical value in the early diagnosis and differential diagnosis of bacterial BSI.关键词
血流感染/降钙素原/C反应蛋白/中性粒细胞与淋巴细胞比值/诊断Key words
bloodstream infection/procalcitonin/C-reactive protein/neutrophil/lymphocyte ratio/diagnosis分类
医药卫生引用本文复制引用
陈萍,周春妹,周佳烨,黄声雷,汪小欢,潘柏申,王蓓丽,郭玮..血清PCT、CRP联合NLR在细菌性血流感染中的应用价值[J].检验医学与临床,2024,21(1):11-15,5.基金项目
福建省厦门市医疗卫生重点项目(YDZX20193502000002). （YDZX20193502000002）
