摘要
目的探讨血液C反应蛋白(CRP)、降钙素原(PCT)联合Toll受体4(TLR-4)检测与腹腔感染类型、严重程度及预后的关系。方法选取2015年1月至2020年1月在恩施土家族苗族自治州中心医院和武汉大学人民医院收治的160例腹腔感染患者作为研究对象,并收集其感染类型、严重程度及预后等临床资料。对比不同感染类型、严重程度及预后患者血清CRP、PCT和TLR-4水平差异,并绘制受试工作者曲线(ROC)探讨三者在腹腔感染类型、严重程度鉴别及预后评估中的价值。结果复杂性腹腔感染组患者CRP、PCT和TLR-4明显高于单纯性腹腔感染组,差异有统计学意义(P<0.05);与CRP、PCT和TLR-4单项预测比较,三者联合在腹腔感染临床类型鉴别诊断中的灵敏度和特异性均明显升高(AUC:0.894,95%CI:0.842~0.937,P=0.001)。重型腹腔感染组患者CRP、PCT和TLR-4明显高于非重型感染组,差异有统计学意义(P<0.05);与CRP、PCT和TLR-4单项预测比较,三者联合在腹腔感染严重程度鉴别诊断中的灵敏度和特异性均明显升高(AUC:0.862,95%CI:0.816~0.922;P=0.007)。死亡组患者CRP、PCT和TLR-4明显高于生存组,差异有统计学意义(P<0.05);与CRP、PCT和TLR-4单项预测比较,三者联合在腹腔感染预后预测中的灵敏度和特异性均明显升高(AUC:0.876,95%CI:0.816~0.942;P=0.001)。结论血液CRP、PCT和TLR-4水平与腹腔感染的感染类型、严重程度及预后密切相关,有望成为腹腔感染患者临床类型、严重程度鉴别及预后评估的有效指标。
Objective To investigate the relationship between the detection of C-reactive protein(CRP),procalcitonin(PCT)and Toll receptor 4(TLR-4)in blood and the type,severity and prognosis of abdominal infection.Methods 160 patients with abdominal infection admitted to the Central Hospital of Enshi Autonomous Prefecture and People′s Hospital of Wuhan University from January,2015 to January,2020 were selected as the study subjects,and clinical data of infection type,severity and prognosis were collected.The levels of CRP,PCT and TLR-4 in serum of patients with different infection types,severities and prognosis were compared,and the receiver operating characteristic curve(ROC)was drawn to explore the value of CRP,PCT and TLR-4 in the identification of abdominal infection types,severities and prognosis.Results CRP,PCT and TLR-4 in patients with complex abdominal infections were significantly higher than those in patients with simple abdominal infections(P<0.05).Compared with CRP,PCT and TLR-4,the sensitivity and specificity of the three-marker combination in the differential diagnosis of clinical types of abdominal infections were significantly higher(AUC:0.894,95%CI:0.842-0.937,P=0.001).The levels of CRP,PCT and TLR-4 in severe,moderate and light abdominal infection groups decreased in turn,and the difference was statistically significant(P<0.05).The CRP,PCT and TLR-4 in the severe abdominal infection group were significantly higher than those in the non-severe infection group(P<0.05).The sensitivity and specificity of the three-marker combination in the differential diagnosis of abdominal infection severity were significantly increased(AUC:0.862,95%CI:0.816-0.922;P=0.007).Compared with CRP,PCT and TLR-4,the sensitivity and specificity of the combination of CRP,PCT and TLR-4 in predicting the prognosis of abdominal infection were significantly higher in the death group(AUC:0.876,95%CI:0.816-0.942;P=0.001).Conclusion The levels of CRP,PCT and TLR-4 in blood are closely related to the type,severity and prognosis of abdominal infection,which is expected to be an effective index for the identification of clinical type,severity and prognosis of abdominal infection.
作者
李叶静
向田
刘蜜
王安
LI Yejing;XIANG Tian;LIU Mi;WANG An(Department of Laboratory,The Central Hospital of Enshi Autonomous Prefecture,Enshi 445000,China;Department of Gastroenterology,People′s Hospital of Wuhan University,Wuhan,430060,China)
出处
《标记免疫分析与临床》
CAS
2020年第10期1735-1740,共6页
Labeled Immunoassays and Clinical Medicine
作者简介
李叶静(1982—),女,副主任技师,本科,研究方向:临床检验方面,E-mail:charles2344@163.com;通讯作者:向田(1981—),女,副教授,博士,研究方向:分子与感染免疫,E-mail:courage_218@163.com。
