HNL在鉴别急性细菌和病毒感染中的临床价值  

Clinical value of HNL in identification of acute bacterial and viral infection

作　　者：金宇亭 孙立宁 凌新辉 李双双 李美慧 宋雪 黄晶[1] JIN Yu-ting;SUN Lining;LING Xin-hui;LI Shuang-shuang;LI Mei-hui;SONG Xue;HUANG Jing(The First Hospital of Jilin University,Changchun,Jilin 130021,China)

机构地区：[1]吉林大学第一医院检验科,吉林长春130021 [2]长春博德生物技术有限责任公司,吉林长春130012

出　　处：《中华医院感染学杂志》2020年第1期40-43,共4页Chinese Journal of Nosocomiology

基　　金：吉林省医疗卫生人才专项学科带头人基金资助项目(JLSCZ2019-028)。

摘　　要：目的研究人类中性粒细胞载脂蛋白(human neutrophil lipocalin,HNL)在鉴别急性细菌和病毒感染中的临床价值。方法选取2017年3-12月吉林大学第一医院收治的细菌感染患者123例作为细菌组,病毒感染患者63例作为病毒组,同期体检的健康人员420名作为对照组。检测所有研究对象血清HNL、C-反应蛋白(CRP)和降钙素原(PCT)水平,分析上述指标对急性细菌感染和病毒感染的临床诊断价值。结果三组研究对象血清HNL、CRP、PCT指标水平比较差异有统计学意义(P<0.05);HNL浓度在细菌组有明显升高,与病毒组和对照组比较差异有统计学意义(P<0.05);血清HNL浓度在病毒组不升高或升高幅度较小,与对照组差异不显著;在cutoff值为115.5 ng/ml时,HNL区分急性细菌和病毒感染的敏感度和特异度分别为0.856、0.631,ROC曲线下面积为0.878,区分急性细菌感染与病毒感染的曲线下面积大于CRP和PCT。结论血清HNL浓度对于鉴别急性细菌和病毒感染具有较高的临床价值,且诊断效能优于CRP和PCT。OBJECTIVE To observe the clinical value of human neutrophil lipocalin(HNL) in identification of acute bacterial and viral infection. METHODS From Mar 2017 to Dec 2017, totally 123 patients with bacterial infection who were treated in the First Hospital of Jilin University were assigned as the bacterial group, and 63 patients with viral infection were set as the control group, meanwhile, 420 healthy people who received physical examination were chosen as the control group.The levels of serum HNL, C-reactive protein(CRP) and procalcitonin(PCT) of all the study objects were detected, and the clinical values of the above indexes in diagnosis of the acute bacterial infection and viral infection were observed. RESULTS There were significant differences in the levels of serum HNL, CRP and PCT among the three groups of study objects(P<0.05);the HNL level of the bacterial group was significantly higher than that of the viral group and the control group(P<0.05).The serum HNL level of the viral group was not elevated or elevated slightly, as compared with the control group, there was no significant difference.When the cutoff value was 115.5 ng/ml, the sensitivity and specificity of the HNL were respectively 0.856 and 0.631 in differential diagnosis of acute bacterial infection and viral infection;the area under ROC curve of the HNL was 0.878 in distinguishing between the acute bacterial infection and the viral infection, larger than that of CRP and PCT. CONCLUSION The serum HNL level has high clinical value in identification of the acute bacterial and viral infection, and it is superior to CRP and PCT in the diagnostic efficiency.

关 键 词：人类中性粒细胞载脂蛋白 急性细菌感染 急性病毒感染 

分 类 号：R446[医药卫生—诊断学]