血清suPAR、BNP检测对血流感染的诊断价值

高海闽　曾镇桦

【摘要】 目的：探讨血清可溶性尿激酶型纤溶酶原激活物受体（suPAR）、B型尿钠肽（BNP）检测对血流感染的诊断价值。方法：回顾性收集笔者所在医院2018年4月-2019年10月确诊的34例血培养阴性患者临床资料为血培养阴性组，选取同期37例血培养阳性患者临床资料为血培养阳性组，另选同期于笔者所在医院体检的31例健康者为对照组，比较三组suPAR、BNP水平，分析各项单一检测对不同血流感染诊断效能。结果：对照组suPAR、BNP水平均低于血培养阴性组、血培养阳性组，血培养阴性组suPAR、BNP水平低于血培养阳性组，差异有统计学意义（P<0.05）;通过ROC曲线可得，suPAR对血流感染阳性诊断截断值为6.69 ng/ml;BNP对血流感染阳性诊断截断值为62.32 pg/ml;血清suPAR、BNP均对血流感染具有较高诊断效能。结论：血清suPAR、BNP对血流感染诊断具有较高诊断价值，可为临床诊断提供重要依据，值得临床推广应用。

【关键词】 血流感染 血清可溶性尿激酶型纤溶酶原激活物受体 B型尿钠肽 诊断价值

doi：10.14033/j.cnki.cfmr.2020.21.026 文献标识码 B 文章编号 1674-6805（2020）21-00-03

Diagnostic Value of Serum SUPAR and BNP in Bloodstream Infection/GAO Haimin， ZENG Zhenhua. //Chinese and Foreign Medical Research， 2020， 18（21）： -65

[Abstract] Objective： To investigate the diagnostic value of serum soluble urokinase plasminogen activator receptor （supAR） and b-type natriuretic peptide （BNP） in bloodstream infection. Method： The clinical data of 34 patients with negative blood culture diagnosed in our hospital from April 2018 to October 2019 were collected retrospectively. The clinical data of 37 patients with positive blood culture in the same period were selected as blood culture positive group， and 31 healthy patients with positive blood culture in the same period were selected as control group. Result： The levels of suPAR and BNP of control group were lower than those of blood culture negative group and blood culture positive group， but those of blood culture negative group were lower than those of blood culture positive group （P<0.05）. ROC curve showed that， Cut-off value of positive diagnosis of bloodstream infection by suPAR was 6.69 ng/ml， Cut-off value of positive diagnosis of bloodstream infection by BNP was 62.32 pg/ml， suPAR， BNP had higher diagnostic efficiency for bloodstream infection. Conclusion： Serum suPAR and BNP have high diagnostic value in the diagnosis of bloodstream infection. Those can provide important basis for clinical diagnosis， be worth for application.

[Key words] Bloodstream infection Serum soluble urokinase plasminogen activator receptor Type B natriuretic peptide Diagnostic value

First-authors address： Zhangzhou Hospital Affiliated to Fujian Medical University， Zhangzhou 363000， China

血流感染是因致病菌入侵血液系統诱发的全身感染性疾病，其病情隐匿，短期内可快速发展，若未得到及时治疗，易导致患者死亡，威胁其生命安全，因此早期准确诊断对临床治疗具有重要意义[1-2]。目前血培养是血流感染诊断金标准，其具有较高诊断价值，但检测时间较长，且不适用于存在抗生素治疗史患者诊断，故应用效果存在一定局限性。血清可溶性尿激酶型纤溶酶原激活物受体（soluble urokinase plasminogen activator，suPAR）、B型尿钠肽（brain natriuretic peptide，BNP）是临床判断细菌感染最常用指标，其可有效反映机体感染情况[3-4]。但临床对上述指标于血流感染中诊断价值报道较少，鉴于此，本研究通过回顾性分析笔者所在医院2018年4月-2019年10月确诊的34例血培养阴性患者、37例血培养阳性患者及31例健康者临床资料，统计其血清检测结果，旨在探讨血清suPAR、BNP检测对血流感染的诊断价值，为临床诊断提供参考，报道如下。……