降钙素原、超敏C反应蛋白及中性粒细胞绝对值动态变化与急性淋巴细胞白血病化疗患儿发生肺部感染的关系  

The relationship between the dynamic changes of procalcitonin,hypersensitive Creactive protein and absolute neutrophil count and lung infection in children with acute lymphoblastic leukemia after chemotherapy

作　　者：梁文英 李永涛 于晓静 王丽 LIANG Wenying;LI Yongtao;YU Xiaojing;WANG Li(Department of Neonatology,Luoyang Maternal and Child Health Hospital,Luoyang 471000,He’nan,China;Department of Pediatrics,Luoyang Maternal and Child Health Hospital,Luoyang 471000,He’nan,China)

机构地区：[1]洛阳市妇幼保健院新生儿科,河南洛阳4710000 [2]洛阳市妇幼保健院儿科,河南洛阳4710000

出　　处：《癌症进展》2020年第18期1881-1884,共4页Oncology Progress

摘　　要：目的探讨降钙素原(PCT)、超敏C反应蛋白(hs-CRP)、中性粒细胞绝对值(ANC)动态变化与急性淋巴细胞白血病(ALL)患儿化疗后发生肺部感染的关系。方法依据化疗后是否发生肺部感染将145例ALL患儿分为感染组(n=65)和非感染组(n=80)。比较两组患儿化疗后第1天(T1)、化疗后第3天(T2)、粒细胞缺乏期出现发热后第1天(T3)、抗感染治疗第7天(T4)的PCT、hs-CRP、ANC。采用受试者工作特征(ROC)曲线分析PCT、hs-CRP、ANC单独及联合检测对ALL患儿发生肺部感染的诊断价值。结果T2、T3、T4时刻,感染组患儿的血清PCT和hs-CRP水平均明显高于非感染组,差异均有统计学意义(P﹤0.01),且均在T3时刻最为显著。T2、T3、T4时刻,感染组患儿的ANC均低于非感染组,差异均有统计学意义(P﹤0.05),且在T3时刻最为显著。PCT、hs-CRP、ANC联合诊断ALL患儿化疗后肺部感染的灵敏度为95.86%,特异度为87.20%,漏诊率为4.14%,误诊率为12.80%,曲线下面积(AUC)为0.914。结论动态监测PCT、hs-CRP、ANC的变化,对于早期发现ALL化疗患儿发生肺部感染具有重要的临床价值。Objective To explore the relationship between the dynamic changes of procalcitonin(PCT),hypersensitive C-reactive protein(hs-CRP),absolute neutrophil count(ANC)and lung infection in children with acute lymphoblastic leukemia(ALL)after chemotherapy.Method According to pulmonary infection after chemotherapy,145 patients with ALL were divided into infected group(n=65)and non-infected group(n=80).PCT,hs-CRP and ANC were compared between the two groups on the first day after chemotherapy(T1),the third day after chemotherapy(T2),the first day after fever in agranulocytosis stage(T3),and the seventh day after anti-infection treatment(T4).Receiver operating characteristic(ROC)curve was used to analyze the clinical value of PCT,hs-CRP,ANC to diagnose lung infection in children with ALL.Result Serum PCT and hs-CRP levels of children in the infected group at T2,T3,and T4 were higher than those in the non-infected group,and were most significant at T3(P<0.01).The ANC level of children in the infected group at T2,T3,and T4 was lower than that of the non-infected group,and was most significant at T3(P<0.05).The combined application of PCT,hs-CRP and ANC to diagnose lung infection in ALL children after chemotherapy has a sensitivity of 95.86%,a specificity of 87.20%,a missed diagnosis rate of 4.14%,a misdiagnosis rate of 12.80%,and area under the curve was 0.914.Conclusion Dynamic monitoring of the changes of PCT,hs-CRP and ANC has important clinical value for early detection of lung infection in children with ALL during chemotherapy.

关 键 词：降钙素原 超敏C反应蛋白 中性粒细胞绝对值 急性淋巴细胞白血病 肺部感染 

分 类 号：R733.7[医药卫生—肿瘤]