摘要目的 探讨降钙素原(PCT)、白细胞(WBC)计数联合呼吸道九项病原体检测(NACD)在呼吸道感染(RTI)诊断中的应用价值.方法 随机选取2014年1月至2015年12月435例RTI患者.按照患者感染病原体类别将其分为细菌感染组(n=185)与非细菌感染组(n=250).分析两组IgM抗体和痰培养阳性率,血清PCT水平、WBC计数,血清PCT水平、WBC计数单独检测与联合检测的敏感度、特异度,不同类型IgM抗体感染病原体分布等.结果 细菌感染组痰培养阳性率(41.62%)高于非细菌感染组(7.60%),IgM抗体阳性率(9.73%)低于非细菌感染组(54.00%),差异有统计学意义(P<0.05).细菌感染组血清PCT水平高于非细菌感染组,WBC计数高于非细菌感染组,差异有统计学意义(P<0.05).血清PCT水平、WBC计数单独检测特异度、敏感度均低于PCT、WBC计数联合检测敏感度、特异度,差异有统计学意义(P<0.05).不同类型IgM抗体感染病原体中,肺炎支原体检出率最高(62.09%),其他依次为副流感病毒(10.46%)、呼吸道合胞病毒(8.50%)、嗜肺军团菌血清I型(7.84%)、乙型流感病毒(7.84%)、肺炎衣原体(3.92%)、腺病毒(2.61%)、Q热立克次体(1.96%).结论 PCT、WBC计数联合NACD检测诊断RTI,可有效提高临床诊断率,准确判断病原体类型,对于临床恰当选择并使用药物,避免滥用抗生素具有重要的价值,

abstractsObjective To investigate the value of procalcitonin (PCT) levels, white blood cell count(WBC) combined with nine-item assay for combined detection (NACD) in diagnosis of respiratory tract infections(RTI).Methods From January 2014 to December 2015, 435 RTI patients were randomly selected.According to original body category, the patients were divided into bacteria infection group (n=185) and non-bacteria infection group (n=250).The IgM antibody and phlegm training positive rates, serum PCT levels, and WBC counts, serum PCT levels, and WBC counts separate detection and joint detection of sensitive degrees, and specific degrees, different type IgM antibody infection disease original body distribution were analyzed.Results The positive rate of bacterial infection in sputum culture (41.62%) was higher in bacteria infection group than that in non-bacterial infection group (7.60%), IgM antibody positive rate (9.73%) was less than that in the non-bacterial infection group (54%), there were significant differences (P<0.05).The serum PCT levels and WBC counts were higher in bacteria infection group than those of non-bacterial infection group, there were significant differences (P<0.05).The single specificity, sensitivity of serum PCT level, WBC count detection was lower than those of the combined PCT, WBC count detection, and there were significant differences (P<0.05).The original body of different type IgM antibody infection was as the follows, pneumonia accounting for 62.09%, Deputy flu virus accounting for 10.46%, and respiratory collection cell virus accounting for 8.5%, and addicted to lung Regiment bacteria serum I type accounting for 7.84%, and b type flu virus accounting for 7.84%, and pneumonia clothing original body accounting for 3.92%, and gland virus accounting for 2.61%, and Q hot rickettsia accounting for 1.96%.Conclusions The combined detection of PCT, WBC and NACD in the diagnosis of RTI, can improve the clinical diagnosis rate, accurately determine the types of pathogens, has great value in clinical appropriate selection and use of drugs, avoid overuse of antibiotics.