感染性疾病检测中的四大名捕

2019-10-29 唐晶 检验医学网

今天williamhill asia 来聊聊目前临床遇到的最常见的感染性疾病,在其实验室辅助检测中也有对应的四大名捕。

四大名捕是温瑞安创作的武侠小说中的四大高手,其成员分别是无情(大师兄 四大名捕之首)、铁手(二师兄)、追命(三师兄)、冷血(四师弟), 四人都是武林中的数一数二的好手,各有其过人之能,人人俱有独特绝技。今天williamhill asia 来聊聊目前临床遇到的最常见的感染性疾病,在其实验室辅助检测中也有对应的四大名捕。

这四大名捕分别是:

白细胞计数(WBC)

C反应蛋白(CRP)

血清淀粉样蛋白A(SAA)

降钙素原(PCT)

WBC(大师兄):病理性白细胞增多,则常见于各种化脓性的球菌或杆菌的感染,如败血症、肺炎、脑膜炎、急性扁桃体炎、急性肾炎、急性胆囊炎及猩红热等;而白细胞的减少,则常见于病毒引起的流感、麻疹、肝炎或伤寒、布氏杆菌病等某些杆菌性疾病。也可见于粟粒性肺结核或败血症等严重感染及磺胺药、砷、苯及放射性物质中毒时。

CRP(二师兄):是急性时相反应蛋白,在感染发生后6-8小时开始升高,24-48小时达到顶峰。升高幅度与细菌感染的程度呈正相关。是鉴别细菌感染与病毒感染的指标,病毒感染时CRP一般不增高,但在自身免疫性疾病时也增高。

SAA(三师兄):是个灵敏的参数,它在炎症反应大约5-6h后开始升高,且上升时间早于CRP,病毒感染时上升显着,病原清除后,SAA又迅速将至正常水平,因此可做为反映病毒感染和炎症控制的敏感指标。

PCT(四师弟):是降钙素的前体物质,一般机体受到细菌感染时,血清PCT水平显着升高,是反映感染程度的重要生物学指标,在脓毒症的早期诊断及预后评估中具有重要价值。研究表明,动态监测血清PCT水平有助于反映脓毒症患者全身炎性反应的严重程度、炎症过程恢复期的筛检、指导治疗及疗效判断。

目前临床常见的检测组合方式如下

多项指标联合诊断临床意义

虽然在感染的诊断方面,WBC、CRP、SAA和PCT都是非特异性感染指标,但是通过这些非特异性感染指标的组合使用,williamhill asia 也可以获得快速的、特异性的辅助诊断,在必要时再结合血培养结果,不仅能够帮助临床医生及时有效的判断感染类型,还能避免抗生素滥用,对临床合理使用药物具有重要意义。

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    2019-11-15 jyzxjiangqin

    感染性疾病检测。

    0

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    2019-11-01 jyzxjiangqin

    感染的治疗。

    0

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