降钙素原与C-反应蛋白的动态监测在人急性布鲁杆菌病诊疗中的应用

doi:10.16150/j.1671-2870.2017.06.011

摘要/Abstract

摘要： 目的: 探讨降钙素原（procalcitonin,PCT）与C-反应蛋白（C-reactive protein,CRP）的动态监测在急性布鲁杆菌病（布病）治疗中的应用价值。方法: 对151例急性布病患者、120例慢性布病患者和72名健康体检者进行PCT、CRP含量检测和白细胞（white blood cell,WBC）计数;并比对布病患者治疗前后的PCT 、CRP水平及WBC计数变化。结果: 151例急性布病患者的平均PCT水平为（3.29±0.49） ng/mL,阳性率为65.56%;平均CRP水平为（24.84±2.95） mg/L,阳性率为56.29%;平均WBC计数为（7.53±3.42）×10⁹/L,阳性率为7.28%。120例慢性布病患者的平均PCT、CRP水平及WBC计数分别为（0.27±0.03） ng/mL、（3.32±0.35） mg/L和（6.27±2.56）×10⁹/L,阳性率分别为7.50%、8.33%和6.67%。急性布病组与慢性布病组、健康对照组间比较,平均PCT、CRP水平差异均有统计学意义(P<0.01),而WBC计数差异无统计学意义(P>0.05)。单项检测时,PCT诊断急性布病的灵敏度、特异度、约登指数、阳性预测值和阴性预测值均高于CRP,而二者联合检测时的诊断灵敏度和阴性预测值较单项检测高,达80.13%及69.38%。急性布病患者治疗后的PCT、CRP水平低于治疗前,两者比较差异均有统计学意义(P均<0.05),而治疗前后的WBC计数变化无统计学意义(P>0.05)。结论: 联合检测PCT和CRP可提高早期诊断急性布病的灵敏度,对动态监测患者抗感染治疗的疗效和预测其转归有一定临床价值。

关键词: 急性布鲁杆菌病, 降钙素原, C-反应蛋白

Abstract: Objective: To investigate the value of dynamic monitoring of procalcitonin(PCT), C-reaction protein (CRP) and WBC in acute brucellosis patients. Methods: A total of 151 patients with acute brucellosis, 120 patients with chronic brucellosis and 72 healthy controls were recruited in this study. The levels of PCT, CRP and WBC were detected and the results before and after therapy were compared. Results: Of the 151 acute brucellosis patients the level of PCT was(3.29±0.49) ng/mL with positive rate of 65.56%, the level of CRP was(24.84±2.95) mg/L with positive rate of 56.29% , and the WBC count was (7.53±3.42)×10⁹/L with positive rate of 7.28%. The levels of PCT, CRP and WBC in 120 cases of chronic brucellosis patients were (0.27±0.03) ng/mL, (3.32±0.35) mg/L and (6.27±2.56)×10⁹/L, respectively, and the positive rates were 7.50%, 8.33% and 6.67% , respectively. The levels of PCT, CRP and WBC in 72 healthy controls were(0.21±0.01) ng/mL, (2.93±0.35) mg/L and (5.91±2.31)×10⁹/L, respectively. The differences in levels of PCT, CRP were statistically significant between acute brucellosis group, chronic brucellosis group and healthy control group(P<0.01), but there was no significant difference in WBC count between the three groups. The sensitivity, specificity, Youden index, positive predictive value and negative predictive value of PCT for diagnosing acute brucellosiswere higher than those of CRP, and the combined detection of PCT and CRP showed the highest sensitivity and negative predictive value. In acute brucellosis group the levels of PCT and CRP after treatment were lower than those before treatment, and the differences were statistically significant(P<0.05). Conclusions: Combined detection of levels of procalcitonin and C-reactive protein could increase the sensitivity for diagnosing acute brucellosis, and monitoring of levels of procalcitonin and C-reactive protein in treatment of acute brucellosis has value in predicting the outcome.

Key words: Brucellosis, Procalcitonin, C-reactive protein

中图分类号:

R378.5

何晶晶, 张雁, 周玉珍, 刘景瑶, 赵冬梅, 郑遵荣. 降钙素原与C-反应蛋白的动态监测在人急性布鲁杆菌病诊疗中的应用[J]. 诊断学理论与实践, 2017, 16(06): 617-621.

HE Jingjing, ZHANG Yan, ZHOU Yuzhen, LIU Jingyao, ZHAO Dongmei, ZHENG Zunrong. Dynamic monitoring of levels of procalcitonin and C-reactive protein in acute brucellosis[J]. Journal of Diagnostics Concepts & Practice, 2017, 16(06): 617-621.

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