• 中国科学论文统计源期刊
  • 中国科技核心期刊
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  • 日本科学技术振兴机构数据库(JST)
临床输血与检验

临床输血与检验 ›› 2019, Vol. 21 ›› Issue (2): 183-186.DOI: 10.3969/j.issn.1671-2587.2019.02.020

• 临床检验 • 上一篇    下一篇

NAP-PCT-CRP联合检测对骨科术后感染的诊断价值*

宋倩   

  1. 054000 河北省冀中能源邢台矿业集团总医院检验科
  • 收稿日期:2018-12-20 出版日期:2019-04-20 发布日期:2019-04-10
  • 通讯作者: 吴占勇,男,主任医师,主要从事骨科专业工作,（Tel）13383096206。
  • 作者简介:宋倩（1984-）,女,河北石家庄人,主管检验师,学士,主要从事微生物检验工作,（Tel）13730098700。
  • 基金资助:
    *本课题受河北省邢台市科技支撑计划（No.1489392217941）资助

Diagnostic Value of Combined Detection of NAP,PCT and CRP in Orthopedic Postoperative Infection

SONG Qian   

  1. Department of Laboratory Diagnostics,General Hospital of Xingtai Mining Group co.,Hebei Jizhong Energy LTD,Xingtai,Hebei054000
  • Received:2018-12-20 Online:2019-04-20 Published:2019-04-10

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摘要： 目的 探讨NAP、PCT、CRP联合检测对骨科术后感染的诊断价值。方法 选择2016年6月~2018年1月收治的骨科行Ⅱ类手术患者304例,按照是否感染分为感染组42例和非感染组262例。2组受试对象于术后第1天收集肘外周静脉血5 mL,采用双抗夹心免疫化学发光法检测PCT,免疫荧光干式定量法检测CRP,NAP检测采用NAP底物-AMP缓冲液法;感染组收集2次标本,置于10 mL无菌试管内,采用药敏试验纸片扩散法（K-B法）对病原菌进行鉴定。根据NAP、PCT、CRP绘制ROC曲线,在最佳截断值下计算各指标曲线下面积（AUC）,并据此评价各指标及联合诊断的效能。结果 304例骨科患者术后发生感染42例,感染率13.8%;42例骨科感染患者中共分离出89株病原菌,其中革兰阳性菌39株占43.8%,革兰阴性菌37株占41.6%,病毒4株占4.5%,支原体6株占6.7%,其他菌株3株占3.4%;感染组的NAP积分、NAP阳性率、PCT及CRP均明显高于非感染组,差异有统计学意义（P﹤0.05）。NAP、PCT、CRP联合检测对骨科术后感染诊断的AUC为0.928,明显高于NAP、PCT、CRP单项检测（AUC：0.667、0.779、0.877,均P﹤0.01）,提示NAP、PCT、CRP联合对骨科术后感染具有较高的诊断价值。结论 NAP、PCT、CRP联合检测对骨科术后感染诊断具有重要的临床价值,能够作为骨科术后感染诊断和疗效判断的重要依据。

关键词: 骨科, 中性粒细胞碱性磷酸酶, 降钙素原, C反应蛋白感染

Abstract: Objective To investigate the diagnostic significance of combined detection of NAP,PCT and CRP in orthopedic postoperative infection. Method sThree hundred and four inpatients who had received Class Ⅱ treatments were divided into infection group （262 cases） and non-infection group （42 cases） from June 2016 to January 2018. 5 mL of venous blood was collected on the first day postoperation. PCT was detected by double-antibody sandwich immunochemiluminescence assay,CRP was tested by immunofluorescence dry-quantitative assay,and NAP assay was carried out with NAP substrate-AMP buffer method. Antibiotic sensitive tests were performed with disc diffusion assay （K-B method）. The ROC curves were analyzed according to the expression levels of NAP,PCT and CRP. Results Among 304 orthopedic patients,42 （13.8%） had postoperative infections,from whom 89 strains of bacteria were isolated that included 39 （43.8%） G-positive and 37 （41.6%） G-negative bacteria,4 （4.5%） viruses,6 （6.7%） mycoplasma,and 3 （3.4%） unidentified microbes. The infection group was significantly higher than the non-infection group in terms of NAP scores,NAP positive rate,PCT and CRP （P<0.05）. The combined detections of NAP,PCT,and CRP for postoperative orthopedic infection was AUC：0.928,which was significantly higher than that of NAP,PCT,and CRP （AUC：0.667,0.779,0.877,P<0.01）,suggesting that joint detections of NAP,PCT,and CRP help with the diagnosis in orthopedics postoperative infection. Conclusion Combined detections of NAP,PCT and CRP are clinically valuable in the diagnosis of orthopedic postoperative infection.

Key words: Orthopedics, infection, Neutrophil, alkaline, phosphatase, Procalcitonin, C-reactive, protein

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