【摘要】 目的:评价外周血细菌内毒素、降钙素原(PCT)、C反应蛋白(CRP)联合检测在下呼吸道感染中的诊断价值。方法:选择某院收治的120例下呼吸道感染患者为研究对象,依据细菌培养结果分为G~+组50例、G~-组40例和非细菌感染组30例。检测各组内毒素、PCT、CRP水平,比较各组阳性率,分析内毒素、PCT和CRP在细菌感染和病原菌种类鉴别中的准确性、敏感性和特异性,并通过受试者工作曲线(ROC)对联合诊断的价值进行评价。结果:G~-组内毒素、PCT水平及阳性率明显高于G~+组,非细菌感染组最低,差异有统计学意义(P <0.05),G~-组和G~+组CRP水平和阳性率明显高于非细菌感染组(P <0.05);内毒素和PCT对细菌感染和病原菌种类鉴别的准确性、敏感性及特异性高于CRP,差异有统计学意义(P <0.05); ROC曲线分析显示,三项指标联合诊断的敏感性为95.6%,特异性为93.7%,准确性为89.6%,诊断G~-的敏感性为90.3%,特异性为87.6%,准确性为83.3%。结论:通过分析细菌内毒素、PCT、CRP联合检测对下呼吸道感染的临床意义发现,联合诊断的应用价值较高,可有效诊断下呼吸道细菌感染和鉴别病原菌种类。更多还原

【Abstract】 Objective: To study values of combined detection of bacterial endotoxin,procalcitonin( PCT) and C reactive protein( CRP) for lower respiratory tract infection. Methods:120 patients with lower respiratory tract infections were included as research objects and were divided into a G~+group( 50 cases),a G~-group( 40 cases) and a non-bacterial infection group( 30 cases). Endotoxin,PCT and CRP levels of each group were detected. The positive rates among the three groups were compared. The diagnostic accuracy,sensitivity and specificity of endotoxin,PCT and CRP were observed,and the value of combined diagnosis was analyzed by ROC( Subject Working Curve Analysis). Results: The levels of endotoxin and positive rate of PCT in the G~-group were significantly higher than those in the G~+group,while those in the non-bacterial infection group were the lowest( P < 0. 05). CRP level and positive rate in the G~-group and the G~+group were significantly higher than those in the non-bacterial infection group( P < 0. 05). The clinical value of endotoxin and PCT in differentiating bacterial infection and pathogenic bacteria was higher than that of CRP( P < 0. 05). ROC analysis showed that the sensitivity,specificity,accuracy in the combined diagnosis were respectively 95. 6%,93. 7%,and 89. 6%. The sensitivity,specificity,accuracy in the diagnosis of G~-were respectively 90. 3%,87. 6%,83. 3%. Conclusion: The analysis of the clinical significance of combined detection of bacterial endotoxin,PCT and CRP for lower respiratory tract infection denotes that the combined diagnosis can effectively diagnose lower respiratory tract bacterial infection and identify pathogenic bacteria,which is of high value.更多还原