血清淀粉样蛋白A、C反应蛋白、降钙素原和血细胞分析检测在3级糖尿病足感染诊断中的应用  

Detection of serum amyloid A,C-reactive protein,procalcitonin and blood cell analysis for the diagnosis of infectious diabetic foot of grade three

作　　者：王瑛[1] 沈建雄[1] 王海英 夏丰[1] WANG Ying;SHEN Jianxiong;WANG Haiying;XIA Feng(Department of Clinical Laboratory,Yueyang Hospital of Integrated Traditional Chinese and Western Medicine,Shanghai University of Traditional Chinese Medicine,Shanghai 200437,China)

机构地区：[1]上海中医药大学附属岳阳中西医结合医院检验科,上海200437

出　　处：《检验医学与临床》2020年第11期1512-1514,共3页Laboratory Medicine and Clinic

基　　金：上海市优秀青年临床医技人才(临床检验专业)培养资助计划(沪医卫基[2016]05号)。

摘　　要：目的探讨血清淀粉样蛋白A(SAA)、C反应蛋白(CRP)、降钙素原(PCT)和血细胞分析联合检测在3级糖尿病足患者感染诊断中的应用。方法收集2015年6月至2018年11月在上海中医医院内分泌病房住院治疗的糖尿病足患者103例,以溃疡组织为湿性伤口并且分泌物细菌培养阳性为标准,将其中54例纳入感染组,49例纳入非感染组,同时选取22例糖尿病患者作为对照组。检测研究对象的SAA、CRP、PCT和血细胞水平。采用受试者工作特征曲线(ROC曲线)分析白细胞数(WBC)、中性粒细胞百分比(NEUT%)、SAA、PCT、CRP诊断糖尿病足患者感染的效能。结果感染组SAA、CRP、PCT、WBC及NEUT%明显高于非感染组及对照组(P<0.05)。非感染组SAA明显高于对照组(P<0.05),其余项目与对照组间差异均无统计学意义(P>0.05)。CRP联合NEUT%诊断3级感染性糖尿病足的效能最好曲线下面积、灵敏度、特异度分别为0.94、91.84%、87.04%。结论SAA或许可作为非感染性糖尿病足血管并发症的预测指标。CRP和NEUT%作为炎症指标,联合检测可提高感染性糖尿病足早期诊断效率,避免截肢的发生,提高糖尿病足患者的生存质量。Objective To investigate the combined detection of serum amyloid A(SAA),C-reactive protein(CRP),procalcitonin(PCT)and blood cell analysis for the diagnosis of infectious diabetic foot of grade three.Methods From June 2015 to November 2018,103 diabetic foot patients who were hospitalized in the endocrine ward of Shanghai Hospital of Traditional Chinese Medicine were collected.The standard was that the ulcer tissue was wet wound and the bacteria culture of secretion was positive.54 cases were included in the infection group,49 cases were included in the non infection group,and 22 diabetic patients without infectious diabetic foot were selected as the control group.SAA,CRP,PCT and blood cells levels were measured.Receiver operating characteristic(ROC)curve was used to analyze the efficacy of WBC,SAA,CRP,PCT and the percentage of neutrophile granulocyte(NEUT%)in the diagnosis of infectious diabetic foot.Results The levels of SAA,CRP,PCT,WBC and NEUT%in infection group were higher than those in non-infection and control group(P<0.05).The level of SAA in non-infectious group was higher than those in control group(P<0.05),and there was no statistical significance for the others compared with control group(P>0.05).ROC curve showed that CRP combined with NEUT%had the best performance for the diagnosis of infectious diabetic foot of grade three,and the area under the curve(AUC),sensitivity and specificity were 0.94,91.84%and 87.04%.Conclusion As an inflammatory factor,SAA can be used as a predictor of vascular complications in non-infectious diabetic foot.The combined detection of CRP and NEUT%can provide a reference for the early diagnosis of infectious diabetic foot.Thus,the amputation can be avoided and the quality of life of diabetic foot patients can be improved.

关 键 词：血清淀粉样蛋白A 降钙素原 C反应蛋白 糖尿病足 

分 类 号：R446.112[医药卫生—诊断学]