降钙素原与高敏C反应蛋白联合检测在老年冠心病患者细菌感染中的临床应用
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李强

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R446

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南京军区联勤十八分部医药科技青年培养项目(18FBQN2014007)


Clinical application of combined detection of procalcitonin and highsensitivity Creactive protein in bacterial infection in elderly patients with coronary heart disease
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    摘要:

    目的比较冠心病患者血液感染性指标的变化,分析降钙素原(PCT)和高敏C反应蛋白(hsCRP)在患者细菌感染中的临床诊断价值。方法选择2013年1月—2014年12月某院收治的冠心病患者,分别于治疗前(D0天)和治疗后第5天(D5)对诊断感染指标PCT、hsCRP、全血白细胞计数(WBC)、中性粒细胞计数(NEU)进行检测,比较细菌感染与非细菌感染组之间的差异,不同部位细菌感染,以及存活组和死亡组之间的差异。结果细菌感染组四项检测指标(PCT、hsCRP、WBC和NEU)均明显高于非细菌感染组;不同感染部位血清PCT和hsCRP水平比较,差异均具有统计学意义(均P<0.001),其中以血流感染患者水平最高[分别为(45.148±46.341)ng/mL、(137.000±87.367)mg/L],其次是胸腹腔感染和呼吸系统感染,泌尿系统感染患者最低[分别为(0.769±1.747)ng/mL、(53.006±45.450)mg/L]。存活组经治疗后各项检测指标均较治疗前低,而死亡组则不断增高。冠心病合并细菌感染患者血清PCT、hsCRP、WBC和NEU曲线下面积分别是0.934、0.856、0.782和0.784。结论联合检测血清PCT和hsCRP不仅可作为鉴别老年冠心病患者早期细菌感染的有效指标,还可用于病情评估,疗效判断,对评估感染的严重程度以及对患者预后的判断具有重要意义。

    Abstract:

    ObjectiveTo compare changes in infectious markers in blood of patients with coronary heart disease (CHD), analyze clinical diagnostic value of procalcitonin (PCT) and highsensitivity Creactive protein (hsCRP) in bacterial infection in patients with  CHD. MethodsPatients with CHD admitted to a hospital between January 2013 and December 2014 were studied. PCT, hsCRP, white blood cell (WBC), and neutrophil (NEU) count were detected before treatment and on the 5th day after treatment, differences between bacterial infected group and noninfected group, infection sites, as well as survival and death groups were compared respectively. ResultsSerum levels of PCT,hsCRP,WBC, and NEU in bacterial infected group were all significantly higher than noninfected group; PCT and hsCRP in infection of different sites were statistically significant (all P<0.001), patients with bloodstream infection had the highest levels ([45.148±46.341] ng/mL, [137.000±87.367]mg/L, respectively),followed by thoracic and abdominal infection,as well as respiratory system infection,while patients with urinary system infection had the lowest levels([0.769±1.747]ng/mL, [53.006±45.450]mg/L, respectively). After treatment, makers in survival group were all lower than before treatment, but in death group were all higher than before treatment. The area under the curve of PCT, hsCRP, WBC, and NEU were 0.934, 0.856, 0.782, and 0.784 respectively. ConclusionThe combined detection of PCT and hsCRP is effective for early diagnosis of bacterial infection in elderly patients with CHD, it is also helpful for assessing disease condition, curative efficacy, and prognosis.

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郭健莲,刘惠娜,肖斌龙,等.降钙素原与高敏C反应蛋白联合检测在老年冠心病患者细菌感染中的临床应用[J]. 中国感染控制杂志,2016,15(10):748-751. DOI:10.3969/j. issn.1671-9638.2016.10.007.
GUO Jianlian, LIU Huina, XIAO Binlong, et al. Clinical application of combined detection of procalcitonin and highsensitivity Creactive protein in bacterial infection in elderly patients with coronary heart disease[J]. Chin J Infect Control, 2016,15(10):748-751. DOI:10.3969/j. issn.1671-9638.2016.10.007.

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  • 收稿日期:2016-01-15
  • 最后修改日期:2016-03-22
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  • 在线发布日期: 2016-10-26
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