血清降钙素原和C反应蛋白联合检测在恶性血液病发热中的诊断价值  

Serum procalcitonin and C-reactive protein detection in diagnosis of fever in hematological maliganancies

作　　者：高然[1] 颜晓菁[1] 于锦香[1] 高峰[1] 蔡大利[1] 王柏勋[1] 潘登[1] 张蕊[1] 王晓雪[1] 李艳[1] 

机构地区：[1]中国医科大学附属第一医院血液内科,沈阳110001

出　　处：《中国医师进修杂志》2015年第4期249-252,共4页Chinese Journal of Postgraduates of Medicine

摘　　要：目的 探讨血清降钙素原（PCT）和C反应蛋白（CRP）在恶性血液病发热中的诊断价值.方法 回顾性分析186例恶性血液病伴发热患者以及30例恶性血液病无发热患者血清PCT及CRP水平.根据入选患者临床特征将其分为感染性发热（165例,其中细菌感染102例、真菌感染27例、病毒感染36例）、非感染性发热（21例）和无发热（30例）,细菌性感染根据血培养结果分为血培养阳性（24例,其中革兰阴性菌感染12例、革兰阳性菌感染12例）与血培养阴性（78例）,比较各类患者血清PCT和CRP水平.结果 感染性发热患者PCT、CRP明显高于非感染性发热患者和无发热患者[1.40 （0.02～54.81） μg/L比0.45 （0.04～12.80） μg/L和0.30 （0.01 ～0.98） μg/L、78.9（3.6 ～ 199.6） mg/L比17.1（2.4～78.9） mg/L和6.7（1.0 ～ 24.2）mg/L],差异有统计学意义（P＜0.05）;非感染性发热与无发热患者CRP比较差异有统计学意义（P＜0.05）,而PCT比较差异无统计学意义（P＞0.05）.细菌感染患者PCT明显高于真菌感染患者和病毒感染患者[1.60（0.28 ～54.81） μg/L比0.55（0.17～9.60） μg/L和0.38（0.02～12.45）μg/L],差异有统计学意义（P＜0.05）;真菌感染患者与病毒感染患者PCT比较差异无统计学意义（P＞0.05）.细菌感染、真菌感染和病毒感染患者CRP比较差异无统计学意义（P＞0.05）.血培养阳性患者PCT和PCT阳性率明显高于血培养阴性患者[2.10（0.35 ～54.81） μg/L比0.78（0.28 ～22.41） μg/L、87.5％ （21/24）比66.7％ （52/78）],差异有统计学意义（P＜0.05）.革兰阴性菌感染患者PCT明显高于革兰阳性菌感染患者[6.64（0.56～54.81） μg/L比2.40（0.35 ～34.81）μg/L],差异有统计学意义（P＜0.05）;两者PCT阳性率比较差异无统计学意义（P＞0.05）.血培养阳性患者与血培养阴性患者、革兰阴性菌感染患者与革兰阳性菌感染患者CRP和CRP阳性率比较差异无统�Objective To explore the diagnosis significance of serum procalcitonin （PCT） and C-reactive protein（CRP） in the fever of hematological maliganancies.Methods The levels of serum PCT and CRP in 186 fever patients with hematological maliganancies and 30 non-fever patients with hematological maliganancies were analyzed retrospectively.According to the clinical characteristics,the patients were divided into infectious fever patients （165 cases）,non-infectious fever patients （21 cases） and non-fever patients （30 cases）.The infectious fever patients were divided into the bacterial infection （102 cases）,the fungal infection （27 cases）,and the virus infection （36 cases）.The patients confirmed with bacteria infection were divided into blood culture positive patients （24 cases,including 12 cases of gram-negative bacteria infection and 12 cases of gram-positive bacteria infection） and blood culture negative patients （78 cases） according to the result of blood culture.The levels of serum PCT and CRP were compared.Results The levels of serum PCT and CRP in infectious fever patients were higher than those in non-infectious fever patients and non-fever patients：1.40（0.02-54.81） μ g/L vs.0.45（0.04-12.80） μ g/L and 0.30（0.01-0.98）μ g/L,78.9（3.6-199.6） mg/L vs.17.1（2.4-78.9） mg/L and 6.7（1.0-24.2） mg/L,and there were significant differences （P 〈 0.05）.The difference of the level of serum CRP between non-infectious fever patients and non-fever patients was significantu （P 〈 0.05）,but the difference of the level of serum PCT between noninfectious fever patients and non-fever patients was no significant （P 〉 0.05）.The level of serum PCT in bacterial infection was higher than that in fungal infection and virus infection：1.60 （0.28-54.81） μ g/L vs.0.55 （0.17-9.60） μg/L and 0.38 （0.02-12.45） μ g/L,and there was significant difference （P〈 0.05）.Tbe dfference of the level of serum PCT between fungal infection and virus infection wa

关 键 词：血液肿瘤 发热 C反应蛋白质 降钙素原 

分 类 号：R733[医药卫生—肿瘤]