本文選題：降鈣素原　切入點：超敏C反應蛋白　出處：《中華醫(yī)院感染學雜志》2017年20期 　論文類型：期刊論文

【摘要】：目的分析降鈣素原(PCT)、超敏C反應蛋白(hs-CRP)、白細胞計數(shù)(WBC)、中性粒細胞計數(shù)(NEU)聯(lián)合檢測在老年冠心病患者細菌感染中的應用價值。方法選取醫(yī)院2014年1月-2016年12月收治的275例老年冠心病患者為研究對象,根據(jù)是否發(fā)生感染分為感染組152例、未感染組123例,對感染患者病原菌、不同感染情況、不同感染部位患者入院時的PCT、hs-CRP、WBC、NEU比較并探討其應用價值。結果發(fā)生感染患者共152例,感染率為55.27%,以呼吸道感染為主;共檢出病原菌273株,其中革蘭陰性菌197株占72.16%,以大腸埃希菌和肺炎克雷伯菌為主;革蘭陽性菌76株占27.84%,以金黃色葡萄球菌為主。兩組各項血液指標,差異均有統(tǒng)計學意義(P均0.05)。血液感染患者的血清PCT和hs-CRP水平最高,其次為胸腹腔感染患者和呼吸道感染患者,泌尿系統(tǒng)感染患者最低。在四種血液指標中,血清PCT水平在診斷老年冠心病患者細菌性感染中的AUC和Youden指數(shù)最高,分別為0.861和0.603,在聯(lián)合檢測四種血液指標時,診斷老年冠心病患者細菌性感染中的AUC和Youden指數(shù)均出現(xiàn)了提高,分別為0.943和0.715。結論老年冠心病患者的細菌性感染率較高,其感染部位和病原菌分布具有一定的特征性,聯(lián)合檢測PCT、hs-CRP、WBC、NEU等血液炎癥指標可用輔助于老年冠心病患者細菌性感染的早期診斷。
[Abstract]:Objective to analyze the procalcitonin (PCT), high sensitive C reactive protein (hs-CRP), white blood cell count (WBC), neutrophil count (NEU) application value of combined detection of bacterial infection in elderly patients with coronary heart disease in the hospital. Methods the January 2014 -2016 year in December 275 cases of elderly patients with coronary heart disease as the research object according to the occurrence of infection, 152 cases were divided into infection group, non infection group 123 cases, infection of pathogens in patients with infection, different situation, different infection sites of patients with PCT, hs-CRP, WBC, NEU and explore its application value. The results of infection in patients with a total of 152 cases, the infection rate was 55.27%, with the respiratory tract infection; pathogenic bacteria were detected in 273 strains, including 197 strains of gram negative bacteria accounted for 72.16%, Escherichia coli and Klebsiella pneumoniae; 76 strains of gram positive bacteria accounted for 27.84%, Staphylococcus aureus in two groups. The blood indexes, the differences were all Statistically significant (P < 0.05). The blood sera of patients infected with PCT and hs-CRP level is the highest, followed by chest abdominal infection patients and patients with respiratory tract infection, urinary tract infection in four patients. The lowest blood index, serum level of PCT in the diagnosis of bacterial infection in elderly patients with coronary heart disease. AUC and Youden were the highest, respectively. 0.861 and 0.603 in the combined detection of four blood indexes in elderly patients with coronary heart disease, diagnosis of bacterial infection in the AUC and Youden index showed increased, respectively 0.943 and 0.715. conclusion in senile patients with coronary heart disease of bacterial infection rate, the infection sites and pathogens distribution has certain characteristics, combined detection of PCT hs-CRP, WBC, NEU, inflammation index of blood used in the early diagnosis of secondary bacterial infection in elderly patients with coronary heart disease.

【作者單位】： 天津市第五中心醫(yī)院檢驗科;
【基金】：天津市濱海新區(qū)衛(wèi)生計生委科技基金資助項目(2015BWKY026)
【分類號】：R446;R541.4

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