孙宇琦??张洋??任春娜??刘婵娟

[摘要] 目的 探讨血清PCT联合CRP对重症感染患者的检测价值。 方法 选取2012年1月～2016年12月于我院ICU入住的感染患者68例，按感染严重程度分为重症感染组37例，局部感染组31例。选取同期入住ICU未合并感染的患者60例为对照组。入住ICU时，抽取外周静脉血20mL，采用双抗夹心免疫化学发光法检测降钙素原（PCT），免疫散射速率比浊法检测C反应（CRP）。PCT≥0.5ng/L定义为阳性，CRP≥10mg/L定义为阳性。 结果 重症感染组和局部感染组血清PCT和CRP水平均显著高于对照组（P<0.05）；且重症感染组血清PCT和CRP水平均显著高于局部感染组（P<0.05）。重癥感染组和局部感染组PCT和CRP阳性率均显著高于对照组（P<0.05）；重症感染组PCT阳性率显著高于局部感染组（P<0.05）；重症感染组和局部感染组CRP阳性率均为100.00%，差异无统计学意义（P>0.05）。PCT敏感性为81.96%，特异性75.16%；CRP敏感性为60.54%，特异性49.25%；联合应用PCT和CRP检测，敏感性为87.25%，特异性81.56%。 结论 血清PCT联合CRP检测，有助于重症感染的早期诊断和鉴别，效果优于单一PCT或CRP检测，值得临床推广应用。

[关键词] 重症感染；降钙素原；C反应蛋白；检测

[中图分类号] R459.7 [文献标识码] A [文章编号] 2095-0616（2017）11-152-03

Diagnostic value of serum PCT combined with CRP in patients with severe infection

SUN Yuqi ZHANG Yang REN Chunna LIU Chanjuan

Clinical Laboratory，Second Affiliated Hospital of Mudanjiang Medical College，Mudanjiang 157000，China

[Abstract] Objective To investigate the diagnostic value of serum PCT combined with CRP in severe infection. Methods 68 cases of infected patients admitted in ICU from January 2012 to December 2016 were selected and divided into severe infection group （37 cases） and local infection group（31 cases），according to the severity of infection.At the Same period，60 patients admitted in ICU without infection were selected as the control group.On the day of admission，20mL of peripheral venous blood was collected.The anti-calcitonin（PCT） was detected by double-antibody sandwich immuno-chemiluminescence method，and the C reaction protein（CRP） was detected by turbidimetric method.PCT≥0.5ng/L was defined as positive，and CRP≥10mg/L was defined as positive. Results The serum levels of PCT and CRP in severe infection group and local infection group were significantly higher than those in control group（P<0.05），and the levels of PCT and CRP in severe infection group were significantly higher than those in local infection group（P<0.05）.The positive rates of PCT and CRP in severe infection group and local infection group were significantly higher than those in control group（P<0.05）.PCT positive rate in severe infection group was significantly higher than that in local infection group（P<0.05）.CRP positive rate was 100.00% for both severe infection group and local infection group，the difference was not statistically significant （P>0.05）.PCT sensitivity was 81.96%，specificity was 75.16%.CRP sensitivity was 60.54%，and specificity was 49.25%.The sensitivity and specificity were 87.25% and 81.56%，respectively. Conclusion Serum PCT combined with CRP detection is helpful to the early diagnosis and differential diagnosis of severe infection.And the effect is better than single PCT or CRP detection，which is worthy of popularization and application.

[Key words] Severe infection；Procalcitonin；C-reactive protein；Inspection

重症监护病房（ICU）收治的患者多数是危重患者，很容易发生感染。尤其是重症感染患者，死亡率高达35%～70%，一直是导致患者死亡的主要原因[1]。重症感染严重影响患者的生活质量和生命安全，是医患关系紧张的原因之一。目前，临床上

尚无统一的重症感染诊断标准。C反应蛋白（C reaction protein，CRP）和降钙素原（procalcitonin，PCT）对于全身炎症反应和感染具有重要的评估价值，在机体受到感染时其水平可明显升高[2-3]。本文通过联合检测血清PCT和CRP，分析其对重症感染的诊断和预后判断价值。现报道如下。

1 资料与方法

1.1 一般资料

选取2012年1月～2016年12月于我院ICU入住的感染患者68例，按感染严重程度分为重症感染组37例，局部感染组（无全身症状的局部感染）31例。……