降钙素原、超敏C反应蛋白、血沉和血清铁蛋白对恶性血液病患者发热的诊断价值  

Diagnostic value of proealcitonin,hypersensitive C-reactive protein,erythrocyte sedimentation rate and serum ferritin in fever patients with hematologic malignancies

作　　者：罗贤生[1] 黄海妹[1] 王智明[1] 陈晓霞[1] 

机构地区：[1]海口市人民医院血液科,海南海口570208

出　　处：《实用医院临床杂志》2013年第6期40-42,共3页Practical Journal of Clinical Medicine

摘　　要：目的探讨降钙素原(proealcitonin,PCT)、超敏C反应蛋白(hypersensitive c-reactive protein,hCRP)、血沉(erythrocyte sedimentation rate,ESR)、血清铁蛋白(serum ferritin;SF)等对恶性血液病患者发热的诊断价值。方法 149例恶性血液病伴发热患者,其中真菌感染26例(真菌感染组)、药物热8例(药物热组)、肿瘤热13例(肿瘤热组)、细菌感染102例(细菌感染组)。对各组PCT、hCRP、ESR和SF测定值进行统计分析。结果细菌感染组PCT水平较真菌感染组、药物热组和肿瘤热组升高并且差异有统计学意义(P<0.05),而各组HCRP、ESR和SF差异无统计学意义(P>0.05)。以1.25 ng/ml为PCT阈值诊断细菌感染的敏感性为84.3%,特异性为95.7%。结论 PCT对恶性血液病患者细菌感染性发热有较好的诊断价值,为临床决策提供依据。而hCRP、ESR、SF等指标特异性不强,不能很好地鉴别恶性血液病患者的发热是细菌感染还是其它因素引起。Objective To explore the diagnostic value of proealcitonin （PCT）, hypersensitive c-reactive protein （hCRP）, e-rythrocyte sedimentation rate （ESR）and serum ferritin （SF）in fever patients with hematologic malignancies. Methods One hundred and forty-nine fever patients with hematologic malignancies were divided into bacteria infection group（ n = 102） ,fungi infection group （n = 26） ,drug fever group（n = 8）and neoplastic fever group（n = 13）. The diagnostic values of these parameters were analyzed for each group. Results PCT levels in the bacteria infection group were significantly higher than that in the fungi infection group, the drug fever group and the neoplastic fever group （ P 〈 0. 05 ） while no significant differences in HCRP, ESR and SF were found among the groups. The sensitivity and specificity in diagnosis of bacterial infection when taking PCT〉1. 25 ng/ml as threshold value were 84. 3% and 95.7% ,respectively. Conclusion PCT had good diagnostic value in bacteria infective fever patients with hematologic malignan-cies.

关 键 词：降钙素原 高敏C反应蛋白 血沉 血清铁蛋白 恶性血液病 发热 

分 类 号：R733[医药卫生—肿瘤]