【摘要】 目的探讨降钙素原(PCT)、白细胞(WBC)水平对急诊发热性疾病的早期诊断价值,分析PCT与急诊发热性疾病严重程度的相关性。方法选取155例急诊成人发热病例,分为细菌感染组91组(其中又分为脓毒症组30例,局部细菌感染组61例)和64例非细菌感染组。分别采用定量免疫荧光酶标法和散射免疫比浊法测定其血清中PCT和WBC水平。结果非细菌感染组的WBC水平明显低于细菌感染组中的脓毒症组及局部细菌感染组,差异均有统计学意义(均P<0.01);细菌感染组中的脓毒症组WBC水平稍高于局部细菌感染组,但两组差异无统计学意义(P>0.05)。细菌感染组的PCT水平明显高于非细菌感染组,差异有统计学意义(P<0.05);细菌感染组中的局部细菌感染组血清PCT水平和半定量分布与非细菌感染组比较无统计学意义(P>0.05),而细菌感染组中的脓毒症组血清PCT水平和半定量分布与局部细菌感染组和非细菌感染组比较,差异均有统计学意义(均P<0.01)。结论联合监测白细胞和降钙素原对发热病人的病因诊断和病情评估更有价值。更多还原

【Abstract】 Objective To investigate the diagnostic significance of procalcitonin(PCT)and white blood cell count(WBC)in patients’ early-stage febrile illness and discuss the relationship between PCT and disease severity of febrile illness. Methods One hundred and fifty-five patients with febrile illness were involved.These patients included 91 with bacterial infection(the group subdivides into 30 patients with sepsis and 61 with part bacterial infection)and 64 with non-bacterial infection.The PCT and WBC were measured with fluorescene enzyme linked immunosorbent assay and scattering immunoturbidimetric assay seperately. Results The WBC in patients with Non-bacterial infection were markedly below to that of patients with sepsis and part bacterial infection(P<0.01).The WBC in patients with sepsis were slightly higher than that of part bacterial infection,but no significant difference were found between both.The PCT in patients with sepsis were significantly higher than patients with nonbacterial infection(P<0.05).The bacterial infection group subdivides into sepsis group and part bacterial infection group,that reanalysis shows the level and the semi-quantitative distribution of PCT both have no significant difference between patients with part bacterial infection and Non-bacterial infection(P>0.05).The level and the semiquantitative distribution of PCT in patients with sepsis were significantly higher than patients with part bacterial infection and Non-bacterial infection(P<0.01). Conclusion The WBC is still a better infectious indicator as a diagnosis of bacterial infection.The PCT is less useful when it evaluates that a fever patient was part bacterial or Non-bacterial infection,but it can assess the severity of bacterial infection.Therefore,combined monitoring of PCT and WBC were considered as a more valuable method on the etiology of fever patients’ diagnosis and evaluating severity.更多还原