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目的比较血浆内毒素、C反应蛋白(C-reactive protein,CRP)及血清降钙素原(procalcitonin,PCT)定量检测在细菌感染性疾病诊断中的作用。方法 284例发热患者,采集血液、痰液等标本行细菌培养,并依据培养结果分为细菌感染组158例及非细菌感染组126例,检测2组血浆内毒素、CRP及血清PCT水平,比较内毒素、CRP及PCT诊断细菌感染性疾病的符合率。结果细菌感染组血浆内毒素、CRP及血清PCT水平均高于非细菌感染组(P<0.01);血浆内毒素、CRP及血浆PCT诊断细菌感染的敏感率分别为91.1%、78.5%、73.4%,特异性分别为93.5%、65.6%和86.6%,血浆内毒素诊断细菌感染的敏感性和特异性高于血浆CRP和血清PCT(P<0.05或P<0.01)。结论血浆内毒素早期诊断及鉴别诊断细菌感染性疾病的准确性优于血浆CRP和血清PCT。
Objective To compare the role of plasma endotoxin, C-reactive protein (CRP) and procalcitonin (PCT) quantitative detection in the diagnosis of bacterial infectious diseases. Methods A total of 284 patients with fever were collected for bacterial culture of blood and sputum. According to the culture results, 158 patients were divided into bacterial infection group and 126 non-bacterial infection group. Plasma endotoxin, CRP and serum PCT levels were compared between the two groups Endotoxin, CRP and PCT coincidence rate of bacterial infections. Results The levels of plasma endotoxin, CRP and serum PCT in bacterial infection group were higher than those in non-bacterial group (P <0.01). The sensitivity rates of plasma endotoxin, CRP and PCT in diagnosing bacterial infection were 91.1%, 78.5% and 73.4% , The specificity was 93.5%, 65.6% and 86.6% respectively. The sensitivity and specificity of plasma endotoxin in diagnosing bacterial infection were higher than those of plasma CRP and serum PCT (P <0.05 or P <0.01). Conclusion The accuracy of the early diagnosis and differential diagnosis of bacterial infectious diseases by plasma endotoxin is better than that of plasma CRP and serum PCT.