hs-CRP对细菌、真菌感染早期鉴别的意义

摘要

目的:探讨超敏C-反应蛋白(hs-CRP)在细菌、真菌感染早期鉴别中的价值.方法:采用免疫荧光法测定革兰阴、阳性细菌感染各50例、真菌感染患者50例及50例病毒感染者(对照组)的血清hs-CRP水平,同时观察白细胞(WBC)、中性粒细胞(PMN)、中性粒细胞比值(N)等炎性指标变化,分析其与不同细菌感染、真菌感染之间的关系.结果:细菌感染患者hs-CRP值明显高于真菌感染和对照组(P＜0.01);细菌感染中革兰阴性菌感染者hs-CRP值又高于革兰阳性菌感染者(P＜0.01),WBC、PMN、N水平与革兰阳性细菌感染者相近(P＞0.05);hs-CRP受试者特征操作曲线下面积(AUC)高于WBC、PMN、N(0.869、0.589、0.546和0.582),革兰阴性细菌感染患者AUC明显高于革兰阳性细菌感染患者(0.869比0.730,P＜0.05).结论:血清hs-CRP是细菌性感染诊断的一个较好生物标志物,其灵敏度和特异度均高于其他炎性指标,可有效鉴别细菌和真菌感染.%Objective To investigate the changes of serum levels of high-Sensitivity C-reactive protein to early distinguish Infections caused by bacteria or fungi. MethodsTo examine the serum level of hs-CRP in patients with Gram-negative bacteria ( n=50 ),gram-positive bacteria ( n=50 ) Fungi( n = 50 ), Virus ( n = 50 ) by immunofluorescence method. Also the levels of white blood cell ( WBC ), polymorphonuclear neutrophils ( PMN ) and neutrophil percentage ( N ) were analyzed. Results The level of hs-CRP increased to different degrees in patients with bacterial infection or fungal infection. The levels of hs-CRP in patients with Gram-negativebacterial infection were higher than in patients with Gram-positive bacterial infection ( P ＜ 0.01 ) , and the levels of WBC, PMN and N have no significant difference between two groups ( P ＞0.05 ). The area under the ROC curve ( AUC ) of hs-CRP was bigger than that of WBC and N ( 0.869 vs 0.589,0.546 , 0.582 ), as well as, the AUC of hs-CRP in patients with Gram-negative bacteria infection was bigger than that of Gram-positive bacteria infection cases ( 0.869 vs 0.730, P＜0.05 ). Conclusion Serum hs-CRP is a better biomarker in the early diagnosis of bacterial infection and it can distinguish the infection from bacteria or fungi effectively.