感染标志物对住院肿瘤患者感染性发热的诊断价值  

Value of Biomarkers of Infection for the Diagnosis of Infectious Fever in Inpatients with Cancer

作　　者：谢华[1] 程凯[1] 屈进文 王友硕 周进[1] 赵新[1] 

机构地区：[1]四川省肿瘤医院,成都610041 [2]宜宾肿瘤医院,四川宜宾644002

出　　处：《肿瘤预防与治疗》2015年第4期196-199,共4页Journal of Cancer Control And Treatment

摘　　要：目的：评价超敏C反应蛋白（hs-CRP）、降钙素原（PCT）及常规血液学指标对于非粒缺性发热的住院肿瘤患者感染的鉴别诊断价值。方法：对2013年10月-2015年4月在我院住院期间出现发热的非粒细胞缺乏的144例肿瘤患者,检测hs-CRP、PCT及常规血液学指标,根据是否感染进行单因素及多因素回归分析。结果：感染性发热组113例,非感染性发热组31例。Logstic回归显示,hs-CRP、PCT、中性粒细胞/淋巴细胞比值（NLR）与感染性发热相关（P=0.001、P=0.017、P=0.012）。ROC曲线分析显示,hs-CRP的AUC为0.823（P〈0.001）,以31.5mg/L为分界值时hs-CRP对于感染性发热的诊断价值最大。PCT≥2.0ng/ml与感染相关性死亡有关（P=0.008）。结论：hs-CRP、PCT、NLR均能提示肿瘤患者的感染性发热,hs-CRP具有较好的诊断效能。PCT明显升高对于肿瘤患者的感染性发热的预后具有提示作用。Objective： To investigate the value of high sensitivity C reactive protein（ hs-CRP）,serum procalcitonin（ PCT） and routine blood indexes in the differential diagnosis of infection in cancer inpatients who got non-neutropenic fever. Methods： Between Oct. 2013 and Apr. 2015,144 cases of cancer inpatients with non-neutropenic fever were included in this study. hs-CRP,PCT and routine blood index were examined. The single factor and multi factor regression analysis were carried out depending on the infection status. Results： One hundred and thirteen patients were diagnosed as infectious fever,while 31 cases were non infectious fever. Logstic regression analysis showed that hs-CRP,PCT and neutrophil-to-lymphocyte ratio（ NLR） were significant correlated with infectious fever（ P = 0. 001、P = 0. 017、P = 0. 012）.The AUC of hs-CRP to diagnose infectious fever in cancer patients was 0. 823（ P〈0. 001） and 31. 5mg / L was its cut off with higher diagnostic accuracy. The noticeably elevated level of PCT（ ≥2. 0ng / ml） was correlated with death induced by infection（ P = 0. 008）. Conclusion： hs-CRP,PCT,NLR could indicate the infectious fever in cancer inpatients. hs-CRP has good diagnostic accuracy. The noticeably elevated level of PCT is correlated with the outcome of cancer patients with infectious fever.

关 键 词：标志物 感染 发热 肿瘤 住院患者 

分 类 号：R730.43[医药卫生—肿瘤]