血清降钙素原、白细胞介素6和C反应蛋白在脓毒血症和全身炎症反应综合征鉴别诊断中的意义

被引:21
作者
杨琴
曹军皓
丁进亚
洪纯
周杉
孙丽
机构
[1] 解放军广州军区武汉总医院检验科
关键词
脓毒血症; 全身炎症反应综合征; 降钙素原; 白细胞介素-6; C-反应蛋白;
D O I
暂无
中图分类号
R459.7 [急症、急救处理];
学科分类号
100231 [临床病理学];
摘要
目的探讨血清降钙素原(PCT)、白细胞介素6(IL-6)和C反应蛋白(CRP)在全身炎症反应综合征(SIRS)和脓毒血症鉴别诊断中的临床意义。方法本研究以重症监护病房(ICU)患者为研究对象,共72例,其中脓毒血症30例,SIRS 42例,动态监测其血清PCT、IL-6和CRP水平变化情况。结果脓毒血症患者血清CRP、PCT和IL-6的水平与SIRS患者相比均有统计学差异。患者在进入ICU后的最初24h内PCT水平<2μg/L,可排除脓毒血症(阴性预期值97%)。反之,PCT水平>10μg/L,很可能为细菌感染引起的脓毒血症(阳性预期值91%)。诊断正确率(DOR)提示:PCT能更准确地鉴别诊断SIRS与脓毒血症。结论在脓毒血症和SIRS鉴别诊断时PCT优于CRP和IL-6。
引用
收藏
页码:675 / 677
页数:3
相关论文
共 7 条
[1]
Biomarkers: Diagnosis and Risk Assessment in Sepsis [J].
Ventetuolo, Corey E. ;
Levy, Mitchell M. .
CLINICS IN CHEST MEDICINE, 2008, 29 (04) :591-+
[2]
Accuracy of procalcitonin for sepsis diagnosis in critically ill patients: systematic review and meta-analysis [J].
Tang, Benjamin M. P. ;
Eslick, Guy D. ;
Craig, Jonathan C. ;
McLean, Anthony S. .
LANCET INFECTIOUS DISEASES, 2007, 7 (03) :210-217
[3]
Procalcitonin as a diagnostic test for sepsis in critically ill adults and after surgery or trauma: A systematic review and meta-analysis [J].
Uzzan, Bernard ;
Cohen, Regis ;
Nicolas, Patrick ;
Cucherat, Michel ;
Perret, Gerard-Yves .
CRITICAL CARE MEDICINE, 2006, 34 (07) :1996-2003
[4]
Markers for sepsis diagnosis: What is useful? [J].
Reinhart, Konrad ;
Meisner, Michael ;
Brunkhorst, Frank M. .
CRITICAL CARE CLINICS, 2006, 22 (03) :503-+
[5]
Diagnostic and prognostic value of procalcitonin in patients with septic shock [J].
Clec'h, C ;
Ferriere, F ;
Karoubi, P ;
Fosse, JP ;
Cupa, M ;
Hoang, P ;
Cohen, Y .
CRITICAL CARE MEDICINE, 2004, 32 (05) :1166-1169
[6]
The diagnostic odds ratio: a single indicator of test performance [J].
Glas, AS ;
Lijmer, JG ;
Prins, MH ;
Bonsel, GJ ;
Bossuyt, PMM .
JOURNAL OF CLINICAL EPIDEMIOLOGY, 2003, 56 (11) :1129-1135
[7]
Procalcitonin for early diagnosis and differentiation of SIRS; sepsis; severe sepsis; and septic shock.[J].F. M. Brunkhorst;K. Wegscheider;Z. F. Forycki;R. Brunkhorst.Intensive Care Medicine.2000, 2