白血病化疗后粒细胞缺乏伴发热患者PCT、SAA、CRP检测的临床意义  

The clinical significance of PCT,SAA and CRP detection in leukaemia patients with fever and agranulocytosis after chemotherapy

作　　者：郝青 甄长青[2] 刘芸[1] 沈亚娟[1] HAO Qing;ZHEN Changqing;LIU Yun;SHEN Yajuan(Department of Clinical Laboratory,Shandong Provincial Hospital Affiliated to Shandong University,Jinan,Shandong 250021,China;Department of Hematology,Shandong Provincial Hospital Affiliated to Shandong University)

机构地区：[1]山东大学附属省立医院临床医学检验部,山东济南250021 [2]山东大学附属省立医院血液科

出　　处：《徐州医科大学学报》2020年第2期142-145,共4页Journal of Xuzhou Medical University

基　　金：山东省自然科学基金面上项目(ZR2017MH088)。

摘　　要：目的探讨检测血清降钙素原(PCT)、淀粉样蛋白A(SAA)、C反应蛋白(CRP)在白血病化疗后粒细胞缺乏伴发热患者中的临床意义。方法选取2016年3月—2018年3月山东大学附属省立医院白血病化疗后中性粒细胞缺乏伴发热患者(174例)的临床资料,其中74例细菌培养阳性者为感染组,同时选取健康体检者67例作为健康对照组,分析2组血清PCT、SAA、CRP的差异,并根据受试者工作特征(ROC)曲线判断PCT、SAA、CRP的诊断效能。结果感染组PCT、SAA、CRP中位数水平明显高于健康对照组,差异有统计学意义(P<0.05)。ROC曲线分析显示PCT诊断细菌感染的效能最好,其截断值、灵敏度、特异度分别为0.285μg/L、86.76%、80.40%。结论血清PCT、SAA、CRP水平的检测在白血病化疗后中性粒细胞缺乏伴感染发热的早期诊断中具有重要意义,PCT在判断发热原因方面具有较高的特异性。Objective To explore the clinical significance of detection of serum calcitonin(PCT),amyloid protein A(SAA)and c-reactive protein(CRP)in leukaemia patients with fever and agranulocytosis after chemotherapy.Methods A retrospective analysis was conducted to evaluate the clinical data of 175 leukaemia patients with agranulocytosis and fever after chemotherapy from March 2016 to March 2018 in the Provincial Hospital Affiliated to Shandong University.Among them,74 patients with positive bacterial culture were assigned to the infection group,and 67 healthy subjects from healthy check-up were selected as the control group.The differences of PCT,SAA and CRP between the two groups were analyzed,and the diagnostic efficacy of PCT,SAA and CRP was judged according to the ROC curve.Results The median levels of PCT,SAA and CRP in the infection group were significantly higher than those in the control group(P>0.05).ROC curve analysis showed that PCT was the best in the diagnosis of bacterial infection,and its cutoff value,sensitivity and specificity were 0.285μg/L,86.76%and 80.40%,respectively.Conclusions The detection of serum PCT,SAA and CRP is of great significance in the early diagnosis of leukemia patients with agranulocytosis,infection and fever after chemotherapy.PCT has high specificity in determining the cause of fever.

关 键 词：白血病 粒细胞缺乏 化疗 感染 降钙素原 淀粉样蛋白A 

分 类 号：R446.11[医药卫生—诊断学]