摘要
目的分析降钙素原(procalcitonin,PCT)和白细胞介素-6(interleukin-6,IL-6)检测在细菌性血流感染鉴别诊断中的应用价值。方法纳入2020年6月—2022年6月就诊的90例细菌性血流感染患者为观察组,同期健康体检者90例为对照组。对入组者的PCT和IL-6水平进行检测,对比两组血清指标水平,并对革兰阳性菌与革兰阴性菌血流感染和不同严重程度感染患者血清指标进行对比。经受试者工作特征(receiver operating characteristic,ROC)曲线评估单项指标和联合指标检测在革兰阳性菌和革兰阴性菌血流感染鉴别诊断中的临床价值。结果观察组PCT水平为(1.48±0.21)ng/mL,IL-6水平为(60.96±7.16)pg/mL,明显高于对照组的(0.03±0.01)ng/mL、(2.18±0.44)pg/mL,比较差异有统计学意义(P<0.05);革兰阳性菌和革兰阴性菌感染患者的IL-6水平比较差异无统计学意义(P>0.05);革兰阴性菌感染患者的PCT水平高于革兰阳性菌感染患者,比较差异有统计学意义(P<0.05);患者感染程度越高,PCT、IL-6水平越高,组间比较差异有统计学意义(P<0.05);ROC曲线鉴别诊断不同类型细菌性血流感染的AUC值为0.993,95%CI为0.946~1.000,灵敏度为95.35%,优于单一指标检测。结论检测PCT和IL-6水平可鉴别诊断细菌性血流感染,也可评估疾病严重程度;联合检测可鉴别诊断革兰阳性菌和革兰阴性菌血流感染,具有临床应用价值。
Objective To analyze the value of detection of procalcitonin(PCT)and interleukin-6(IL-6)in the d i ff e r e n t ial d iagnosis o f b acter ial b loodstr eam infection.Methods A total of 90 patients with bacterial bloodstream infection from June 2020 to June 2022 were enrolled and set as the observation group,and 90 healthy physical examiners were selected as the control group during the same period.The levels of PCT and IL-6 of all the subjects were detected,and the serum index levels of the two groups were compared,and the serum index of patients with Gram-positive bacteria bloodstream infection and Gram-negative bacteria bloodstream infection and different severity were compared.The receiver operating characteristic(ROC)curve was used to evaluate the clinical value of single index and combined index in the differential diagnosis of Gram-positive and Gram-negative bacterial bloodstream infections.Results The levels of PCT and IL-6 in the observation group were(1.48±0.21)ng/mL and(60.96±7.16)pg/mL,which were significantly higher than(0.03±0.01)ng/mL and(2.18±0.44)pg/mL in the control group,and the differences were statistically significant(P<0.05).There was no significant difference in IL-6 level between patients with Gram-positive bacterial infection and Gram-negative bacterial infection(P>0.05),while the PCT level of patients with Gram-positive bacterial infection was higher than that of patients with Gram-negative bacterial infection,and the difference was statistically significant(P<0.05).The higher the degree of infection,the higher the level of PCT and IL-6,and the difference between the groups was statistically significant(P<0.05).The AUC value of ROC curve in the differential diagnosis of different types of bacterial bloodstream infection was 0.993,95%CI was 0.946-1.000,the sensitivity was 95.35%,which was better than that of single indicator detection.Conclusion Detection of PCT and IL-6 levels can be used for differential diagnosis of bacterial bloodstream infection and evaluation of disease severity.Combined detection can be used in the differential diagnosis of Gram-positive and Gram-negative bacterial bloodstream infections,which has clinical application value.
作者
谢中意
李致富
黄昀
XIE Zhongyi;LI Zhifu;HUANG Yun(Department of Clinical Laboratory,Shaodong People's Hospital,Shaodong Hu’nan 422000,China)
出处
《中国卫生标准管理》
2023年第12期108-112,共5页
China Health Standard Management
关键词
细菌性血流感染
鉴别诊断
降钙素原
白细胞介素-6
受试者工作特征曲线
诊断效能
bacterial bloodstream infection
differential diagnosis
procalcitonin
interleukin-6
receiver operating characteristic curve
diagnostic efficiency
