降钙素原在恶性血液病化疗后中性粒细胞缺乏合并感染中的临床意义  

The Clinical Significance of Procalcitonin in Hematological Malignancies with Agranulocytosis and Infection After Chemotherapy

作　　者：张素平[1] 万鼎铭[1] 曹伟杰[1] 邵运丽[1] 金婷[1] 张媛[1] 石聪聪[1] 

机构地区：[1]郑州大学第一附属医院血液科,河南郑州450052

出　　处：《肿瘤基础与临床》2012年第1期17-20,共4页journal of basic and clinical oncology

摘　　要：目的探讨降钙素原(PCT)在恶性血液病化疗后中性粒细胞缺乏患者合并感染时对病原体诊断的临床意义。方法根据感染的微生物类型,将135例入组患者分为细菌感染组、真菌感染组和病毒感染组;细菌感染组中微生物学确诊为G-菌感染组和G+菌感染组。除行常规血培养及感染灶分泌物培养等检查外,均在发热12 h内行血清PCT测定。PCT测定采用快速半定量固相免疫测定法。综合分析患者的临床表现、微生物检查、影像学检查及治疗疗效回顾性诊断患者感染的微生物类型。结果细菌感染组血清PCT值较真菌感染组及病毒感染组均明显增高,差异均有统计学意义(P均<0.05);真菌感染组与病毒感染组比较差异无统计学意义(P>0.05);G-菌感染组较G+菌感染组PCT值增高(P<0.05)。结论在恶性血液病化疗后中性粒细胞缺乏合并感染的患者中,血清PCT值对预测细菌感染是一个快速可靠的指标。血清PCT值越高,细菌感染可能性越大,G-菌感染可能性更大。对于真菌感染、病毒感染诊断具有阴性预测意义。Objective To explore the clinical significance of procalcitonin（PCT） for the pathogen diagnosis in hematological malignancies with agranulocytosis and infection after chemotherapy. Methods According to the type of microbial infections,135 patients enrolled in this research were divided into the bacterial infection group,the fungal infection group and the virus infection group.The patients confirmed with bacteria infection were divided into the G-bacteria group and the G＋ bacteria group.All the patients in this research received routine blood culture,foci secretion culture and others,and the serum PCT were determined after fever within 12 hours by half quantitative solid phase immunoassays.On the basis of the clinical presentations,microbiological examination,imaging and therapeutic effect of the patients,the microbial infection types of the patients were diagnosed. Results The serum PCT levels of the bacteria infection group were significantly higher than those of the fungal infection group or the virus infection group,the differences were statistically significant（P0.05）.The difference was not statistically significant between the fungal infection group and the virus infection group（P0.05）.The serum PCT levels of the G-bacteria infection group were higher than those of the G＋ bacteria infection group（P0.05）. Conclusion Serum PCT is a fast and reliable marker for the diagnoses of bacterial infections in hematological malignancies with agranulocytosis and infection after chemotherapy.The higher level of serum PCT is,the greater likelihood of bacteria infection,especially more G-bacteria infection probability.PCT can be used as a predictive negative marker for patients with fungal infection and virus infection.

关 键 词：降钙素原 恶性血液病 中性粒细胞缺乏 感染 

分 类 号：R733[医药卫生—肿瘤]