恙虫病严重程度与血清降钙素原水平的相关性  

Association between Severity of Scrub Typhus and Serum Procalcitonin Level

作　　者：李久荣 刘群[1] 陈春成[2] 马爱平[1] LI Jiurong;LIU Qun;CHEN Chuncheng;MA Aiping(Depatment of Respiratory,the First Hospital Affiliated to Xiamen University,Xiamen,Fujian 361003,China;Department of Pathology,Zhongshan Hospital Affiliated to Xiamen University,Xiamen,Fujian 361004,China)

机构地区：[1]厦门大学附属第一医院呼吸内科,福建厦门361003 [2]厦门大学附属中山医院病理科,福建厦门361004

出　　处：《中国医学科学院学报》2018年第3期334-337,共4页Acta Academiae Medicinae Sinicae

基　　金：福建省卫生计划生育委员会青年科研课题(2016-2-62);福建省自然科学基金(2015J01551)~~

摘　　要：目的研究恙虫病患者严重程度与血清降钙素原(PCT)水平的相关性。方法回顾性分析2016年1月至2017年10月在厦门大学附属第一医院住院并经厦门市疾病预防控制中心确诊的58例恙虫病患者的临床资料,根据临床表现及相关实验室检查,依据病情严重程度将患者分为Ⅰ、Ⅱ、Ⅲ、Ⅳ级4个级别组,对各组患者的年龄、出现症状至就诊时间、住院天数及血清PCT水平进行比较。结果 58例患者中,Ⅰ、Ⅱ级均为17例,Ⅲ级11例,Ⅳ级13例;各级别组患者在年龄(F=0.618,P=0.606)、出现症状至医院就诊时间(F=1.744,P=0.169)和住院天数(F=0.398,P=0.755)方面差异均无统计学意义。Ⅳ级患者的中位PCT水平为2.60(1.33,61.08)ng/ml,明显高于Ⅰ级患者的0.24(0.10,0.33)ng/ml(Z=-4.63,P=0.000)、Ⅱ级患者的0.29(0.21,0.51)ng/ml(Z=-4.63,P=0.000)和Ⅲ级患者的1.33(0.89,2.41)ng/ml(Z=-2.09,P=0.040);Ⅲ级患者的PCT水平亦明显高于Ⅰ级患者(Z=-4.16,P=0.000)和Ⅱ级患者(Z=-3.83,P=0.000);Ⅰ级和Ⅱ级患者之间的PCT水平差异无统计学意义(Z=-1.37,P=0.170)。PCT水平与恙虫病严重程度呈显著正相关(r=0.804,P=0.000)。结论血清PCT水平与恙虫病患者的病情严重程度呈正相关,血清PCT水平可作为评估恙虫病患者病情严重程度的潜在指标之一。Objective To explore the association between the severity of scrub typhus（ ST） and the serum procalcitonin（ PCT） level. Methods The clinical data of 58 ST patients who were treated in the First Affiliated Hospital of Xiamen University and confirmed by Xiamen Municipal Center for Disease Prevention and Control（ CDC） from January 2016 to October 2017,were retrospectively analyzed. According to clinical manifestations and related laboratory tests,these patients were divided into four grades： Ⅰ,Ⅱ,Ⅲ,and Ⅳ. These four grade groups were compared in terms of age,interval from symptom onset to hospital presentation,hospitalization days,and serum PCT level. Results These 58 patients were divided into four grade groups： grade Ⅰgroup（ n = 17）,grade Ⅱ group（ n = 17）,grade Ⅲ group（ n = 11）,and grade Ⅳ group（ n = 13）. No significant difference was found among these four groups in terms of age（ F = 0. 618,P = 0. 606）,interval from symptom onset to hospital presentation（ F = 1. 744,P = 0. 169）,and hospitalization days（ F = 0. 398,P =0. 755）. However,the median serum PCT level in the grade Ⅳ patients [2. 60（1. 33,61. 08） ng/ml] was significantly higher than those in grade I [0. 24（ 0. 10,0. 33） ng/ml; Z =-4. 63,P = 0. 000 ],grade Ⅱ[0. 29（0. 21,0. 51） ng/ml; Z =-4. 63,P = 0. 000 ],and grade Ⅲ [1. 33（ 0. 89,2. 41） ng/ml;Z =-2. 09,P = 0. 040]. The median serum PCT level in the grade Ⅲ patients was also significantly higher than grade Ⅰ（ Z =-4. 16,P = 0. 000） and grade Ⅱ（ Z =-3. 83,P = 0. 000）. There was no significant difference between the grade Ⅰ patients and grade Ⅱ patients（ Z =-1. 37,P = 0. 170）. There was significantly positive correlation between PCT level and the severity of ST（ r = 0. 804,P = 0. 000）. Conclusion There is positive correlation between serum PCT level and the severity of ST,and serum PCT level may be a biomarker in assessing the severity of ST.

关 键 词：恙虫病 恙虫病东方体 降钙素原 

分 类 号：R563[医药卫生—呼吸系统]