关键词: 降钙素原, C反应蛋白, 血流感染

Abstract: Objective To evaluate the signification of procalcitonin(PCT) combined C reactive protein(CRP) detection in the early diagnosis of bloodstream infection. Methods PCT,CRP,white blood cell(WBC) count and erythrocyte sedimentation rate (ESR) were determined in 156 patients with bloodstream infection,and 105 patients with negative bloodstream infection were as controls.The receiver operating characteristic(ROC)curve was analyzed for PCT,CRP,WBC count and ESR by SPSS 19.0 software.The optimal values were obtained by calculating the area under ROC curve(AUC).The sensitivity and specificity of PCT combined CRP detection in the diagnosis of bloodstream infection were calculated. Results The AUC of PCT,CRP,WBC count and ESR were 0.890,0.714,0.712 and 0.545,respectively.The diagnosis criteria at 0.307 of the ROC curve resulted in the greatest Youden index with the sensitivity of 67.6% and the specificity of 88.6%. The positive and negative predictive values were 82.1% and 78.0%,and the positive and negative likelihood ratio were 5.93 and 0.37. The concordance rate was 79.5%,and Kappa value was 57.4%. When the cut-off value was 0.307 ng/mL, there were statistical significances between the 2 groups(χ²=52.807,P<0.001). The sensitivity of 91.1% and the specificity of 51.7% were in parallel detection of PCT and CRP,and the sensitivity of 55.5% and the specificity of 96.6% were in serial detection. Conclusions PCT is a valuable predictor for the early diagnosis of bloodstream infection.PCT combined CRP detection could improve the sensitivity and specificity.

Key words: Procalcitonin, C reactive protein, Bloodstream infection