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目的分析降钙素原(PCT)、超敏C反应蛋白(hs-CRP)、白细胞计数(WBC)、中性粒细胞计数(NEU)联合检测在老年冠心病患者细菌感染中的应用价值。方法选取医院2014年1月-2016年12月收治的275例老年冠心病患者为研究对象,根据是否发生感染分为感染组152例、未感染组123例,对感染患者病原菌、不同感染情况、不同感染部位患者入院时的PCT、hs-CRP、WBC、NEU比较并探讨其应用价值。结果发生感染患者共152例,感染率为55.27%,以呼吸道感染为主;共检出病原菌273株,其中革兰阴性菌197株占72.16%,以大肠埃希菌和肺炎克雷伯菌为主;革兰阳性菌76株占27.84%,以金黄色葡萄球菌为主。两组各项血液指标,差异均有统计学意义(P均<0.05)。血液感染患者的血清PCT和hs-CRP水平最高,其次为胸腹腔感染患者和呼吸道感染患者,泌尿系统感染患者最低。在四种血液指标中,血清PCT水平在诊断老年冠心病患者细菌性感染中的AUC和Youden指数最高,分别为0.861和0.603,在联合检测四种血液指标时,诊断老年冠心病患者细菌性感染中的AUC和Youden指数均出现了提高,分别为0.943和0.715。结论老年冠心病患者的细菌性感染率较高,其感染部位和病原菌分布具有一定的特征性,联合检测PCT、hs-CRP、WBC、NEU等血液炎症指标可用辅助于老年冠心病患者细菌性感染的早期诊断。
Objective To analyze the value of combination of PCT, hs-CRP, WBC and NEU in the diagnosis of bacterial infection in elderly patients with coronary heart disease. Methods A total of 275 elderly patients with CHD who were hospitalized from January 2014 to December 2016 in our hospital were enrolled in this study. According to whether they were infected or not, 152 cases were divided into infection group and 123 cases without infection group. The pathogenic bacteria, different infections, PCT, hs-CRP, WBC, NEU at different infection sites were compared and their value of application was compared. Results A total of 152 patients were infected with the infection rate of 55.27%, with respiratory infection as the main pathogen; 273 strains of pathogens were detected, of which 197 strains were Gram-negative bacteria, accounting for 72.16%; Escherichia coli and Klebsiella pneumoniae were Lord; Gram-positive bacteria 76 strains accounted for 27.84%, mainly Staphylococcus aureus. The two groups of blood indicators, the differences were statistically significant (P all <0.05). Serum PCT and hs-CRP were the highest in patients with blood-borne infection, followed by patients with thoracic-abdominal and abdominal infection and respiratory tract infections, urinary tract infections were the lowest. Among the four blood parameters, the serum PCT level had the highest AUC and Youden index in the diagnosis of bacterial infections in elderly patients with coronary heart disease, which were 0.861 and 0.603, respectively. When the four blood parameters were tested in combination, the bacterial infection in elderly patients with coronary heart disease The AUC and Youden indices both showed an increase of 0.943 and 0.715 respectively. CONCLUSIONS: The prevalence of bacterial infection in elderly patients with coronary heart disease is high. The distribution of infection sites and pathogenic bacteria in elderly patients with coronary heart disease has certain characteristics. Combined detection of blood inflammatory markers such as PCT, hs-CRP, WBC and NEU may be helpful to bacterial infections in elderly patients with coronary heart disease Early diagnosis.