标题：血清PCT、IL-6联合超敏CRP检测对产后革兰氏阴性杆菌感染早期诊断的价值

      作者：蔡巧青 1，江丽 1，陈细英 1，刘晅 2，陈丕绩 2
    (1.北京大学深圳医院妇产科，广东 深圳 518036；
2.深圳市盐田区人民医院检验科，广东 深圳 518081)

      卷次： 2016年27卷17期

      【摘要】 目的 探讨血清降钙素原 (PCT)、白细胞介素-6 (IL-6)联合超敏C反应蛋白(hs-CRP)检测早期诊断产
后革兰氏阴性杆菌感染的临床价值。方法 选取2014年9月至2015年9月期间在我院妇产科实行剖宫产分娩，且
经临床表现及细胞培养证实为革兰氏阴性杆菌感染者100例(观察组)，另选取我院自然分娩的健康产妇100例(对
照组)，各种标本培养均为阴性，对所有产妇的血清PCT、IL-6、hs-CRP水平和阳性率，以及三者的敏感度、特异度和
细菌感染诊断价值进行测定。结果 观察组产妇血清 PCT、IL-6和 hs-CRP水平分别为 (3.58±0.15) ng/mL、
(39.25±6.08) ng/L和(14.37±2.31) mg/L，均高于对照组的(0.36±0.11) ng/mL、(12.83±5.12) ng/L和(3.21±0.03) mg/L，差
异均有统计学意义(P<0.05)；观察组产妇PCT、IL-6、hs-CRP阳性率分别为 76.0% (76/100)、72.0% (72/100)和 43.0%
(43/100)，均明显高于对照组的 8.0% (8/100)、15.0% (15/100)和 4.0% (4/100)，差异均有统计学意义(P<0.05)；PCT的
敏感度为 81.7%，特异度为 95.75%；IL-6的敏感度为 92.5%，特异度为 60.3%；hs-CRP的敏感度为 70.9%，特异度为
92.2%。其中，IL-6的敏感度最高，PCT和hs-CRP的特异度均较高。结论 血清PCT、IL-6联合hs-CRP检测对诊
断产妇产后是否有革兰氏阴性杆菌感染有一定的临床价值。

      【关键词】 降钙素原；白细胞介素6；超敏C反应蛋白；革兰氏阴性杆菌；产后；感染

      【中图分类号】 R714.46 【文献标识码】 A 【文章编号】 1003—6350（2016）17—2778—03


Early diagnostic value of joint determination of hs-CRP, IL-6 and PCT in postpartum infection of
Gram-negative bacillus.
CAI Qiao-qing 1, JIANG Li 1, CHEN Xi-ying 1, LIU Xuan 2, CHEN Pi-ji 2. 1. Department of
Gynaecology and Obstetrics, Peking University Shenzhen Hospital, Shenzhen 518036, Guangdong, CHINA; 2. Department of
Clinical Laboratory, Shenzhen 518081, Guangdong, CHINA

【Abstract】 Objective To investigate the early diagnostic value of joint determination of high-sensitivity C-reac-
tive protein (hs-CRP), interleukin-6 (IL-6) and procalcitonin (PCT) in post postpartum infection of Gram-negative bacil-
lus. Methods The clinical records of 100 patients with Gram-negative bacillus infection after cesarean section in the De-
partment of Gynecology and Obstetrics in our hospital between September 2014 and September 2015 were selected as
case group. And 100 women of spontaneous labor in our hospital without infection were selected as control group. The
serum levels of PCT, IL-6, hs-CRP and the positive rate of all the women were measured. The sensitivity, specificity and
diagnostic value of bacterial infection were determined. Results The serum levels of PCT, IL-6 and hs-CRP in the case
group were (3.58±0.15) ng/mL, (39.25±6.08) ng/L and (14.37±2.31) mg/L, which were significantly higher than those in
the control group of (0.36±0.11) ng/mL, (12.83±5.12) ng/L, (3.21±0.03) mg/L (P<0.05). The positive rates of PCT, IL-6
and hs-CRP in the case group were 76.0% (76/100), 72.0% (72/100), 43.0% (43/100), which were significantly higher
than those in the control group of 8.0% (8/100), 15.0% (15/100), 4.0% (4/100), with P<0.05. The sensitivity and specific-
ity was 81.7% and 95.75% for PCT, 92.5% and 60.3% for IL-6, 70.9% and 92.2% for hs-CRP. The sensitivity of IL-6
was the highest, and the specificity of PCT and hs-CRP were high. Conclusion Joint determination of hs-CRP, IL-6
and PCT in postpartum infection of Gram-negative bacillus has certain clinical value.

      【Key words】 Procalcitonin; Interleukin-6; C-reactive protein; Gram-negative bacillus; Postpartum; Infection
·论 著·
6350.2016.17.009