血清降钙素原与超敏C反应蛋白联合检测在脓毒症诊断中的意义

新生儿感染诊断中降钙素原及超敏C-反应蛋白检测的临床意义杨爱春【摘要】目的探讨采用超敏C-反应蛋白(hs-CRP)和降钙素原(PCT)作为检测指标在新生儿感染诊断中的临床价值.方法选取本院新生儿科2014年9月至2016年10月期间所收治新生儿60例作为观察对象,所有患儿均经诊断确诊为感染性疾病,将其作为观察组,另选取同期本院体检健康新生儿60例作为对照组,对两组新生儿进行血清降钙素原、超敏C反应蛋白检测,其中超敏C反应蛋白行散射比浊法检测,降钙素原行双抗体夹心精标法检测,对两组新生儿相关指标检测结果进行对比分析.结果观察组新生儿其白细胞计数、hs-CRP水平、PCT水平均明显高于对照组,差异具有统计学意义(P＜0.05);同PCT相比,hs-CRP对于新生儿感染性疾病的诊断灵敏度、特异性均处于较低水平;同单一指标检测相比,PCT联合hs-CPR检测对于新生儿感染性疾病的诊断灵敏度、特异性均处于较高水平.结论在新生儿感染性疾病中,血清超敏C-反应蛋白、降钙素原均存在显著的特异性变化,可作为感染性疾病的鉴别、诊断指标,其中降钙素原对于新生儿感染性疾病的诊断灵敏度、特异性优于超敏C-反应蛋白,采用二者进行联合检测可有效提高对于此类患儿的临床诊断价值.%Objective To evaluate high sensitivity C-reactive protein (hs-CRP) and procalcitonin (PCT) as the detection index in the diagnosis of neonatal infection.Methods Sixty newborn infants were enrolled in the Department of Neonatology from September 2014 to October 2016.All the children were diagnosed as infectious diseases and treated as observation group.60 cases of neonatal healthy neonates were taken as the control group.Serum neonates were tested for PCT and Hs-CRP.Hs-CRP was detected byturbidimetric assay.Standard test and the two groups of neonatal related indicators test results were compared and analyzed.Results The white blood cell count,hs-CRP level and PCT level of the neonates in the observation group were significantly higher than those in the control group,and the difference was significant (P ＜ 0.05).Compared with the PCT,hs-CRP for neonatal infectious diseases in the diagnosis of sensitivity and specificity were at a low level;compared with a single index test,PCT joint hs-CPR detection of neonatal infectious disease diagnostic sensitivity andspecificity were at a high level.Conclusion In neonatal infectious diseases,serum allergy-sensitive C-reactive protein and procalcitoninhave significant specific changes,and can be used as identification of infectious diseases anddiagnostic indicators.Calcitonin is betterfor neonatal infectious diseases of the diagnostic sensitivity and specificity than the high-sensitivity C-reactive protein.The combination of the two can be used to effectively improve the clinical diagnosis of such children.【期刊名称】《标记免疫分析与临床》【年(卷),期】2017(024)012【总页数】4页(P1393-1395,1402)【关键词】新生儿感染性疾病;超敏C-反应蛋白;降钙素原;诊断价值【作者】杨爱春【作者单位】江苏省海安县中医院儿科,江苏海安226600【正文语种】中文感染性疾病是一种常见的新生儿疾病，由于新生儿免疫机能较弱，如不对其进行及时治疗极易造成患儿病情持续恶化引发重症感染，严重时可造成死亡［1］。

降钙素原与C反应蛋白联合检测的临床意义发表时间：2016-07-14T15:57:14.643Z 来源：《健康世界》2016年第10期作者：郭鲁泱[导读] 探讨降钙素原（PCT）与C反应蛋白（CRP）联合检测在局部细菌感染和脓毒血症诊断中的临床应用价值。

博士后研究员美国明尼苏达大学赫默尔研究所明尼苏达州 55912摘要：目的探讨降钙素原（PCT）与C反应蛋白（CRP）联合检测在局部细菌感染和脓毒血症诊断中的临床应用价值。

方法分别对来自医院重症监护室的40例脓毒血症患者和来自医院住院病房的50例局部细菌感患者进行降钙素原和C-反应蛋白检测；同时收集20例体检中心健康人群标本作为对照组进行检测。

结果 40例全身细菌性感染患者降钙素原和C反应蛋白检测结果均显著高于20例健康对照组标本检测结果差异显著（P<0.01），有统计学意义。

50例局细菌感染患者降钙素原检测结果与健康对照组降钙素原检测结果相比无显著差异（P>0.05），无统计学意义；50例局部细菌感染患者C反应蛋白检测结果显著高于健康对照组C反应蛋白检测结果（P<0.01），差异显著，有统计学意义。

结论降钙素原与C反应蛋白联合检测有助于临床医师诊断患者是否存在局部细菌感染或全身性细菌感染，为临床合理使用抗生素提供依据。

关键词：降钙素原；C反应蛋白；全身性细菌感染；局部细菌感染[Abstract] Object Study of calcitonin（PCT）and C-reactive protein（CRP）joint detection for localized bacterial infection patients and sepsis in the diagnosis of patients with clinical application value.Methods Respectively to the hospital intensive care unit from 40 cases of sepsis patients and from hospital wards of localized bacterial patients a sense of procalcitonin and C-reactive protein test. At the same time，20 healthy persons were tested as control group. Results Results of 40 cases of systemic bacterial infection in patients with pocalcitonin and C reactive protein test results were significantly higher than 20 cases of healthy control group，the difference was significant（P<0.01），there was statistical significance. compared with healthy control group pocalcitonin test results no significant difference（P > 0.05），no statistical significance；50 cases of localized bacterial infection in patients with C reactive protein test results were significantly higher than the healthy control group C reactive protein test results（P < 0.01），the significant differences，were statistically significant. Conclusions The combined detection of procalcitonin and C reactive protein test result can help clinicians to diagnose the presence of local bacterial infection or systemic bacterial infection，and provide the basis for clinical rational use of antibiotics.[Key] Procalcitonin C reactive protein Systemic bacterial infection Locally bacterial infection降钙素原（Pocalcitonin，PCT）作为一种新的衡量机体细菌感染程度的血清检测指标，近年来被临床广泛用于机体细菌感染严重程度的诊断以及临床细菌感染治疗效果的评估指标。

血清降钙素原和C-反应蛋白在CAP检测的临床意义摘要】目的探讨血清降钙素原(PCT)及C—反应蛋白(CRP)在社区获得性肺炎(CAP)患者早期诊断及病情严重程度评估等方面的临床意义。

方法选取研究对象共140例，包括确诊CAP患者70例(A组)，正常健康者70例(B组)，分别测定并两组患者血清PCT和CRP水平，比较其特异性和敏感性。

血清PCT采用电化学发光法测定(仪器是罗氏COBAS-e601)，血清CRP采用贝克曼IMMAGE 800测定。

结果测得社区获得性肺炎患者的血清PCT(0.946±0.103ng/ml)和CRP(79.89±21.43mg/L)平均水平比正常健康者水平(0.030±0.013ng/ml和6.12±1.05mg/L)明显升高；PCT的特异性为97.5%，显著高于CRP的特异性(83.8%)，两组数据比较差异性显著(P<0.05)。

结论测定社区获得性肺炎患者的血清PCT和CRP对CAP的诊断及评估均具有重要的诊断价值，尤其是PCT水平在早期诊断CAP及指导治疗等方面具有重要临床意义。

【关键词】血清降钙素原 C-反应蛋白 CAP 临床意义社区获得性肺炎(CAP)是临床常见呼吸道感染性疾病。

临床治疗时常规细菌培养和药敏实验以指导治疗，但一般痰培养未能获得满意阳性率，因此血清降钙素原和C-反应蛋白等炎性标志物对CAP诊断和炎症程度评估得到更多重视[1]。

本文研究正常健康者及CAP患者PCT和CRP水平及其敏感性和特异性，旨在探讨PCT和CRP检测在CAP的临床意义，现报告如下。

1 对象和方法1.1 临床资料选取2011年5月至2011年9月我院收治的CAP患者70例(A 组)，根据其病史、临床表现及相关检查，所有患者CAP诊断明确，并且未使用任何抗生素治疗。

招募志愿正常健康者70例(B组)。

A组中男性39例，女性31例，平均年龄36.2岁。