| ObjectivesThe combination of procalcitonin(PCT),hypersensitive C-reactive protein(hs-CRP),interleukin-6(IL-6)detection and blood culture were used to investigate whether they can improve the diagnostic accuracy and rate of bloodstream infection,and provide a theoretical basis for the clinical diagnosis and treatment of bloodstream infection.MethodsUsed a experimental study,patients from February 2012 to January 2016 in our hospital ICU ward 153 cases of infection in other parts of the PCT,hs-CRP,IL-6 detection,and the detection sensitivity of blood cultures,comparing the different methods,the accuracy and specificity of diagnosis,and the combined use of the above method could improve the sensitivity of diagnosis of bloodstream infection the accuracy and specificity of diagnosis.The database was established by Epidata 3.0 software,the data was analyzed by using SPSS20.0 statistical software.The receiver operating characteristic(ROC)curve and area under the evaluation of procalcitonin,hypersensitive C-reactive protein,interleukin-6 and blood culture on clinical diagnosis of bloodstream infection,and the sensitivity,specificity,accuracy of diagnosis,diagnostic information and corresponding Youden index.Results1.Blood culture negative group included in the study of PCT(0.45±0.42)ng/ml,hs-CRP(24.27±5.35)mg/L,IL-6(261.55±29.50)pg/ml;the positive blood culture group were included in the study of PCT(4.98±0.89)ng/ml,hs-CRP(35.35±10.50)mg/L,IL-6(429.43±154.35)pg/ml;In the healthy control group,PCT(0.03±0.01)ng/ml,hs-CRPN was(4.05±1.65)mg/L,IL-6 was(0.58±0.05)pg/ml,and the levels of serum PCT,hs-CRP and IL-6 in the three groups were significantly different(P<0.05).The levels of serum PCT,hs-CRP and IL-6 were the highest in the positive group,followed by the negative group and the lowest in the control group.2.In the blood culture positive group,the levels of PCT,hs-CRP and IL-6 in the serum of the pulmonary infection subjects were significantly higher than those in the blood culture negative group(P<0.05).3.The positive study group in gram negative bacteria infected with PCT was significantly higher than that of gram positive bacteria infection and had a significant difference among the blood culture(P<0.05),no infection of gram negative bacteria and gram positive bacteria infection were found in hs-CRP,IL-6 compared with statistical difference(P>0.05).4.PCT,hs-CRP,IL-6 and PCT,hs-CRP,IL-6 and area under the curve of blood culture were 0.958,0.772,0.833.0.984,and PCT,hs-CRP,IL-6 and blood culture in the area under the curve,PCT,IL-6,hs-CRP,PCT again,the lowest maximum Youden index was 0.82,up breakpoint corresponding to 1.28 ng/ml,sensitivity prediction of flow the infection was 88%,the specificity was 94%,hs-CRP largest Youden index was 0.55,the diagnostic points corresponding to 31.68 mg/L,the sensitivity of prediction of bloodstream infection was 63%,the specificity was 92%,IL-6 largest Youden index was 0.71,the diagnostic points corresponding to 304.37 pg/ml,the sensitivity of prediction of bloodstream infection was 78%,the specificity was 93%.PCT,hs-CRP,IL-6 and blood culture largest Youden index was 0.92,namely PCT>1.28 ng/ml,hs-CRP>31.68 mg/L,the predictive sensitivity of bloodstream infection in cultured IL-6>304.37 94%pg/ml combined with blood,the specificity was 98%.ConclusionsPCT,hs-CRP,IL-6 combined with blood culture have the highest accuracy in the diagnosis of bloodstream infection.Combined detection can improve the diagnosis rate and accuracy rate of bloodstream infection. |
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