血清超敏C-反应蛋白与降钙素原及内毒素对白血病患者化疗后感染的诊断价值研究  

Value of serum high-sensitivity C-reactive protein,procalcitonin and endotoxin in diagnosis of infections in leukemia patients after chemotherapy

作　　者：宋春鸽[1] 马若巾[1] 杨晓煜[1] 王琰[1] 庞素蕾[1] 马云云 

机构地区：[1]郑州大学第五附属医院血液科,河南郑州450052

出　　处：《中华医院感染学杂志》2017年第21期4898-4901,共4页Chinese Journal of Nosocomiology

摘　　要：目的研究血清超敏C-反应蛋白(hs-CRP)、降钙素原(PCT)和内毒素(ET)在白血病患者化疗后并发感染应用价值。方法选取2013年11月-2016月10月医院白血病化疗患者170例,其中化疗后并发感染98例设为感染组,非感染患者72例设为非感染组,同期再选取健康体检者50例作对照组,检测感染患者化疗时、感染时、感染控制后和完全缓解后以及非感染患者化疗期间、健康体检人群入选时血清hs-CRP、PCT、ET水平。结果感染组hs-CRP、PCT、ET水平感染时、感染控制后高于化疗时,差异有统计学意义(P<0.05),感染控制后、完全缓解后水平低于感染时,完全缓解后水平低于感染控制后,差异有统计学意义(P<0.05);非感染组、对照组hs-CRP、PCT、ET水平低于感染组感染时、感染控制后,差异有统计学意义(P<0.05);PCT曲线下面积(AUC)0.940,高于hs-CRP、ET,差异有统计学意义(P<0.05);PCT截断值0.745ng/mL,特异性91.67%、敏感度87.76%。结论血清PCT、hs-CRP、ET水平检测在临床诊断白血病化疗后感染中具有一定价值且有助于病情评估、指导临床治疗,尤其PCT具有较高诊断敏感度与特异性,而联合检测有助于提高白血病化疗后并发感染诊断准确率。OBJECTIVE To study the value of serum high-sensitivity C-reactive protein（hs-CRP）,procalcitonin（PCT）and endotoxin（ET）in diagnosis of infections in leukemia patients after chemotherapy.METHODS A total of 170 leukemia patients who received chemotherapy in the hospital from Nov 2013 to Oct 2016 were enrolled in the study,98 patients who were complicated with infection after the chemotherapy were assigned as the infection group,72 patients without infection were set as the non-infection group,meanwhile,50 healthy people who received physical examination were chosen as the control group.The levels of serum hs-CRP,PCT and ET of the three groups of participants were determined during the chemotherapy,when they had infections,after the infections were controlled,after complete remission,and at the enrollment.RESULTS The levels of hs-CRP,PCT and ET of the infection group were higher when they had infection or after the infection was controlled than during the chemotherapy（P〈0.05）,which were lower after the infection was controlled or after complete remission than when they had the infections and were lower after the complete remission than after the infections were controlled,and there was significant difference（P〈0.05）.The levels of hs-CRP,PCT and ET of the non-infection group and the control group were lower than those of the infection group when they had the infections or after the infections were controlled（P〈0.05）.The area under curve（AUC）of the PCT was significantly higher than that of the hs-CRP and ET（P〈0.05）.The cutoff value of the PCT was 0.745 ng/mL,the specificity 91.67%,the sensitivity 87.86%.CONCLUSIONThe levels of serum PCT,hs-CRP and ET have certain value in clinical diagnosis of the infection in the leukemia patients after the chemotherapy and are conducive to the evaluation of illness condition,in particularly,the PCT has high diagnostic sensitivity and specificity,while the combined detection may improve the accuracy of diagnosis of complicated infection in the le

关 键 词：白血病 化疗 感染 HS-CRP PCT ET 

分 类 号：R557[医药卫生—血液循环系统疾病]