【摘要】 目的：观察血清降钙素原（Procalcitonin,PCT）、C反应蛋白（C-reactive Protein,CRP）、肝素结合蛋白（HeparinBinding Protein,HBP）联合检测在血流感染中的诊断价值。方法：随机选取2017年12月-2019年12月佛山市禅城区中心医院接收的176例疑似血流感染患者，根据临床诊断结果分为血流感染组、局部感染组，同期选取76例健康体检人群作为对照组，对患者血常规及血清PCT、HBP进行实验室检查，比较三组检查结果，并比较血流感染组中不同菌种的实验室指标。采用受试者工作特征（Receiver Operating Characteristic,ROC）曲线分析PCT、CRP、HBP及三项指标联合检测的诊断价值，并以血液培养为金标准分析各指标及联合检测的灵敏度、特异度及准确性。结果：血流感染组的PCT、CRP和HBP水平显著高于局部感染组、对照组（P均<0.05）；局部感染组的PCT、CRP和HBP水平显著高于对照组（P均<0.05）。革兰阴性菌感染患者的PCT显著高于革兰阳性菌感染患者（P <0.001），其HBP水平显著低于革兰阳性菌感染患者（P <0.001），两者CRP水平差异无统计学意义（P <0.079）。ROC曲线下面积显示PCT为0.706,CRP为0.671,HBP为0.723。联合检测的灵敏度、特异度及准确性均显著高于3项指标单一检测（P均<0.05）。结论：血清PCT、CRP及HBP联合检测可显著提升血液感染患者的诊断效能，且PCT与HBP可有效区分革兰阳性菌和革兰阴性菌，对于临床早期诊断血流感染具有较高的应用价值。更多还原

【Abstract】 Objective: To observe the value of serum procalcitonin plus C reactive protein and heparin-binding protein in diagnosing bloodstream infection. Methods: One hundred and seventy-six cases from December 2017 to December 2019 were randomly selected.According to the results of clinical diagnosis, the 176 cases were divided into the bloodstream infection group, the local infection group.And 76 health people were selected as the control group at the same time. The patients’ blood routine, and serum PCT and HBP levels were examined in laboratory, and the results in the three groups were compared. The laboratory indexes of different bacterial species in the bloodstream infection group were compared. The diagnostic value of PCT plus CRP and HBP detection was analyzed by ROC curve.The blood culture was used as the gold standard to analyze the sensitivity, specificity and accuracy of each index detection and combined detection. Results: The levels of PCT, CRP and HBP in the bloodstream infection group were significantly higher than those in the local infection group and the control group(all P<0.05). The PCT, CRP and HBP levels in the local infection group were significantly higher than the control group(all P<0.05). The PCT levels in patients with gram-negative bacteria infection were significantly higher than those in patients with gram-positive bacteria infection(P<0.001), the HBP levels in patients with gram-negative bacteria infection were significantly lower than those in patients with gram-positive bacteria infection(P<0.001), and there was no significant difference in CRP level between the two groups(P<0.079). AUC of ROC showed that PCT was 0.706, CRP was 0.671, and HBP was 0.723. The sensitivity, specificity and accuracy of combined detection were significantly higher than single detection of three indicators(P<0.05). Conclusion: PCT plus CRP and HBP detection can significantly improve the diagnosis efficiency of blood infection, and PCT and HBP can effectively distinguish gramnegative bacteria and gram-positive bacteria. It has a high application value for early clinical diagnosis of blood infection.更多还原