| 苏敏,李亚周,张景皓,李茹,方毅.炎症指标单独诊断及联合诊断在老年血流感染中的价值[J].老年医学与保健,2026,32(3):432-435 |
| 炎症指标单独诊断及联合诊断在老年血流感染中的价值 |
| Value of combined and individual detection of inflammatory indicators in diagnosis of bloodstream infections in elderly patients |
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| DOI：10.3969/j.issn.1008-8296.2026.03.019 |
| 中文关键词: 老年 血流感染 炎症指标 联合诊断 诊断价值 |
| 英文关键词: elderly bloodstream infection inflammatory indicator combined diagnosis diagnostic value |
| 基金项目:20244Y0152:上海市卫生健康委员会科研项目;231107010165520:教育部卓越工程师教育培养计划项目产学合作协同育人项目 |
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| 中文摘要: |
| 目的 探讨全血 C 反应蛋白(CRP)、降钙素原(PCT)、肝素结合蛋白(HBP)及肝素结合蛋白/单核细胞比值(HMR)单独及联合检测在老年患者血流感染(BSI)诊断中的价值.方法 回顾性选取 2023 年 1 月至 12 月复旦大学附属华东医院诊治的156 例老年患者的临床资料,根据同期血培养结果分为阳性组(n=79)和对照组(n=77).阳性组即为 BSI 老年患者,2 组患者均无其他合并感染.比较 2 组患者的 CRP、PCT、HBP 及 HMR 的指标值,采用二元 Logistic回归方法和 ROC 曲线分析方法,分析以上指标值对 BSI 诊断的辅助价值.结果 阳性组患者 CRP、PCT、HBP 及 HMR水平显著高于对照组,且差异有统计学意义(P<0.05).二元 Logistic 回归分析显示,HMR 诊断 BSI 的预测价值最高(OR=1.123,95%CI:1.316～5.352,P<0.05).单项指标诊断 BSI 的曲线下面积(AUC)中,HMR 的 AUC 最大(0.878);此外,联合检测中,PCT 与HMR 联合的AUC 最高(0.880).结论 CRP、PCT、HBP、HMR 指标值可用于老年患者 BSI 早期诊断,且联合检测可提升诊断价值. |
| 英文摘要: |
| Objective To investigate the value of combined and individual detection of whole blood C-reactive protein(CRP),procalcitonin(PCT),heparin-binding protein(HBP),and heparin-binding protein to monocyte ratio(HMR)in diagnosis of bloodstream infections(BSI)in elderly patients.Methods The clinical data of 156 elderly patients diagnosed and treated in Huadong Hospital Affiliated to Fudan University from January to December 2023 were retrospectively selected.Patients were divided into positive group(n=79)and control group(n=77)based on blood culture results during the same period.The positive group consisted of elderly BSI patients.Both groups had no other concurrent infections.The levels of CRP,PCT,HBP and HMR were compared between the two groups.Binary logistic regression and receiver operating characteristic(ROC)curve analysis were used to evaluate their auxiliary value in diagnosing BSI.Results The levels of CRP,PCT,HBP and HMR in the positive group were significantly higher than those in the control group(P<0.05).Binary logistic regression analysis showed that HMR had the highest predictive value for BSI diagnosis(OR=1.123,95%CI:1.316-5.352,P<0.05).Among the individual indicators,HMR had the largest area under the curve(AUC)for BSI diagnosis(0.878).Additionally,among the combined detection methods,the combination of PCT and HMR had the largest AUC(AUC=0.880).Conclusion The levels of CRP,PCT,HBP and HMR can be used for early diagnosis of BSI in elderly patients,and combined detection may enhance diagnostic value. |
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