本文選題：降鈣素原 + C-反應(yīng)蛋白��； 參考：《中華醫(yī)院感染學(xué)雜志》2017年02期

【摘要】：目的探討降鈣素原(PCT)、C-反應(yīng)蛋白(CRP)、白細(xì)胞介素-6(IL-6)及白細(xì)胞計(jì)數(shù)(WBC)多指標(biāo)檢測(cè)對(duì)于復(fù)雜性上尿路感染導(dǎo)致尿膿毒血癥的價(jià)值,以期為尿膿毒血癥尋找早期鑒別診斷指標(biāo)。方法選取2013年1月-2016年1月醫(yī)院泌尿外科收治復(fù)雜性上尿路感染患者且術(shù)后并發(fā)尿膿毒血癥患者84例為觀察組,另選同期住院術(shù)后發(fā)生尿路感染患者60例為對(duì)照1組,同期住院膿毒血癥患者60例為對(duì)照2組;觀察組與對(duì)照2組確診后抽血送檢,對(duì)照1組確診尿路感染后抽血送檢;觀察3組患者PCT、CRP、IL-6及WBC水平,根據(jù)膿毒血癥嚴(yán)重程度及治療結(jié)局將觀察組及對(duì)照2組進(jìn)行劃分,觀察不同嚴(yán)重程度及治療結(jié)局患者觀察指標(biāo)水平變化。結(jié)果觀察組各項(xiàng)觀察指標(biāo)均高于對(duì)照1組(P0.05),CRP、IL-6及WBC指標(biāo)低于對(duì)照2組(P0.05),觀察組與對(duì)照2組嚴(yán)重患者各項(xiàng)指標(biāo)均高于同組非嚴(yán)重患者(P0.05),觀察組不同程度患者CRP、IL-6及WBC指標(biāo)水平均低于對(duì)照2組同程度(P0.05),觀察組與對(duì)照2組死亡患者各項(xiàng)指標(biāo)均高于同組存活患者(P0.05),觀察組不同治療結(jié)局患者CRP、IL-6及WBC指標(biāo)水平低于對(duì)照2組同結(jié)局患者(P0.05);尿膿毒血癥各項(xiàng)指標(biāo)均呈正相關(guān)(P0.05),靈敏度及特異性依次為PCT、CRP、IL-6、WBC。結(jié)論 PCT、CRP、IL-6及WBC水平與尿膿毒血癥病情均具有相關(guān)性,隨病情程度增加而增高,PCT對(duì)疾病早期診斷具有重要意義,但對(duì)鑒別病源部位效果欠佳,聯(lián)合檢驗(yàn)PCT、CRP對(duì)復(fù)雜性上尿路感染導(dǎo)致的膿毒血癥意義重大。
[Abstract]:Objective to investigate the value of multiple indexes of serum calcitonin proto PCTU C-reactive protein (CRP), interleukin-6 (IL-6) and white blood cell count (WBC6) in the diagnosis of urinary sepsis caused by complicated upper urinary tract infection, in order to find the early differential diagnostic index for urinary sepsis. Methods from January 2013 to January 2016, 84 patients with complicated upper urinary tract infection and complicated with urinary sepsis were selected as the observation group, and 60 patients with postoperative urinary tract infection in the same period were selected as the control group. In the same period, 60 patients with sepsis were selected as the control group, the patients in the observation group and the control group were given blood samples after diagnosis, and in the control group 1, the levels of IL-6 and WBC were observed after the diagnosis of urinary tract infection in the three groups. According to the severity of sepsis and the outcome of treatment, the observation group and the control group were divided into two groups. Results all the observed indexes in the observation group were higher than those in the control group 1 (P 0.05) and the WBC index was lower than that in the control group 2 (P 0.05). All the indexes in the observation group and the control group were higher than those in the control group (P 0.05). The levels of IL-6 and WBC finger in the observation group were higher than those in the control group (P 0.05). The standard level was lower than that of the control group (P 0.05), the indexes of the death patients in the observation group and the control group were higher than those in the same survival group (P 0.05). The levels of IL-6 and WBC in the patients with different therapeutic outcomes in the observation group were lower than those in the same outcome patients in the control group (P 0.05). All the indexes of urinary sepsis were positively correlated with P0.05, and the sensitivity and specificity were as follows: PCT CRP IL-6 and WBC. Conclusion the levels of IL-6 and WBC are correlated with the severity of urinary sepsis. It is important for the early diagnosis of the disease to increase with the increase of the severity of the disease, but it is not effective in differentiating the location of the disease. Combined detection of PCTU CRP is of great significance for sepsis caused by complicated upper urinary tract infection.
【作者單位】： 鄭州大學(xué)附屬南陽市中心醫(yī)院泌尿外科;南陽醫(yī)學(xué)高等�？茖W(xué)校醫(yī)教室;
【基金】：河南省衛(wèi)生計(jì)生委科技攻關(guān)項(xiàng)目(201405011)
【分類號(hào)】：R691.3;R459.7

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