摘要
目的分析降钙素原(PCT)、超敏C反应蛋白(hs-CRP)、白细胞计数(WBC)、中性粒细胞计数(NEU)联合检测在老年冠心病患者细菌感染中的应用价值。方法选取医院2014年1月-2016年12月收治的275例老年冠心病患者为研究对象,根据是否发生感染分为感染组152例、未感染组123例,对感染患者病原菌、不同感染情况、不同感染部位患者入院时的PCT、hs-CRP、WBC、NEU比较并探讨其应用价值。结果发生感染患者共152例,感染率为55.27%,以呼吸道感染为主;共检出病原菌273株,其中革兰阴性菌197株占72.16%,以大肠埃希菌和肺炎克雷伯菌为主;革兰阳性菌76株占27.84%,以金黄色葡萄球菌为主。两组各项血液指标,差异均有统计学意义(P均<0.05)。血液感染患者的血清PCT和hs-CRP水平最高,其次为胸腹腔感染患者和呼吸道感染患者,泌尿系统感染患者最低。在四种血液指标中,血清PCT水平在诊断老年冠心病患者细菌性感染中的AUC和Youden指数最高,分别为0.861和0.603,在联合检测四种血液指标时,诊断老年冠心病患者细菌性感染中的AUC和Youden指数均出现了提高,分别为0.943和0.715。结论老年冠心病患者的细菌性感染率较高,其感染部位和病原菌分布具有一定的特征性,联合检测PCT、hs-CRP、WBC、NEU等血液炎症指标可用辅助于老年冠心病患者细菌性感染的早期诊断。
OBJECTIVE To analyze the application value of combined detection of procalcitonin（PCT）,high sensitive C reactive protein（hs-CRP）,white blood cell count（WBC）and neutrophil count（NEU）in bacterial infections in elderly patients with coronary heart disease.METHODS A total of 275 cases of elderly patients with coronary heart disease from Jan.2014 to Dec.2016 were selected as the research subjects.According to whether the infections occurred,they were divided into infection group（152 cases）and non-infection group（123 cases）.The occurrence of bacterial infections during hospitalization of the patients were observed and recorded.The pathogens,infection situation,and PCT,hs-CRP,WBC and NEU levels of the patients with different infected sites were analyzed and compared,and the application value was investigated.RESULTS There were 152 cases that had infections,and the infection rate was 55.27%,which was mainly respiratory tract infections.Totally 273 strains of pathogens were detected,including 197 strains of gram-negative bacteria,accounting for 72.16% and mainly were Escherichia coli,and 76 strains of gram-positive bacteria,accounting for 27.84%,which were mainly Klebsiella pneumoniae.The blood indexes of the two groups had significant differences（P〈0.05）.The PCT and hsCRP levels of patients with bloodstream infections were the highest,followed by patients with chest abdominal infections and patients with respiratory tract infections,and those of patients with urinary tract infections were the lowest.In such four blood indexes,AUC and Youden indexes of the serum PCT level in the diagnosis of the bacterial infections in elderly patients with coronary heart disease were the highest,which were respectively 0.861 and 0.603.When the combined detection of such four blood indexes was applied,AUC and Youden indexes in the diagnosis of the bacterial infections in elderly patients with coronary heart disease increased significantly,which were respectively 0.943 and 0.715.CONCLUSION The incidence of bacterial infections in elderly patients with coronary heart disease is high,the infected sites and the distribution of pathogens have certain characteristics.The application of combined detection of PCT,hs-CRP,WBC and NEU can be auxiliary tools in the diagnosis of bacterial infections in elderly patients with coronary heart disease.
作者
冯贺强
张彩红
李玉芬
褚玲玲
FENG He-qiang ZHANG Cai-hong Li Yu-fen CHU Ling-ling(The Fifth Central Hospital of Tianjin , Tianjin 300450, Chin)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2017年第20期4681-4684,共4页
Chinese Journal of Nosocomiology
基金
天津市滨海新区卫生计生委科技基金资助项目(2015BWKY026)
关键词
降钙素原
超敏C反应蛋白
老年
冠心病
细菌感染
Procalcitonin
High sensitive C reactive protein
Elderly
Coronary heart disease
Bacterial infection
