降钙素原和C反应蛋白在恶性肿瘤合并发热患者早期诊断中的临床应用  

Clinical application of procalcitonin and C-reactive protein in early diagnosis of malignant tumor with fever

作　　者：常炳庆[1] 张超彦[2] 任欣 于洪远[3] 汪晓 刘春艳 王玉 李爽[1] 李超 黄新春[1] CHANG Bingqing;ZHANG Chaoyan;REN Xin;YU Hongyuan;WANG Xiao;LIU Chunyan;WANG Yu;LI Shuang;LI Chao;HUANG Xinchun(Department of Hematology,Beijing Aerospace General Hospital,Beijing 100076,China;Department of Occupational Medicine,Beijing Aerospace General Hospital,Beijing 100076,China;Department of Clinical Laboratory,Beijing Aerospace General Hospital,Beijing 100076,China)

机构地区：[1]北京航天总医院血液科,北京100076 [2]北京航天总医院职业病科,北京100076 [3]北京航天总医院检验科,北京100076

出　　处：《国际检验医学杂志》2020年第21期2672-2675,共4页International Journal of Laboratory Medicine

摘　　要：目的探讨血清降钙素原(PCT)和C反应蛋白(CRP)在恶性肿瘤合并发热患者早期诊断中的临床应用价值。方法回顾2019年7-12月该院恶性肿瘤合并发热的住院患者临床资料,选取发热24 h内检测PCT、CRP的患者共208例作为研究对象,根据病原学、影像学、症状、体征、治疗效果等将其分为感染患者178例和非感染患者30例。采用SPSS17.0软件进行统计分析。结果(1)感染患者PCT阳性率(67.4%)及CRP阳性率(91.6%)均高于非感染患者的10.0%和46.4%,差异均有统计学意义(P<0.05);(2)PCT及CRP双阳性、单阳性、双阴性患者的感染率依次为98.2%、81.3%、36.4%,双阳性患者的感染率明显高于单阳性,单阳性又明显高于双阴性,差异均有统计学意义(P<0.05);(3)PCT、CRP阳性患者的感染率分别为97.6%、92.2%,均明显高于阴性患者(68.2%、48.3%),差异均有统计学意义(P<0.05),阳性患者的感染风险分别是阴性患者的18.6倍、12.6倍;(4)PCT、CRP阳性率与感染率有一致性,但吻合度不高(Kappa系数=0.326、0.445;P<0.05)。结论恶性肿瘤合并发热患者早期检测PCT和CRP呈阳性,尤其是PCT阳性或二者均阳性,提示有感染性发热;但阴性结果不能完全排除感染,需要综合分析,谨慎诊断。Objective To investigate the clinical value of serum procalcitonin(PCT)and C reactive protein(CRP)in the early diagnosis of malignant tumor with fever.Methods The clinical data of the inpatients with malignant tumor complicated with fever in the hospital from July to December 2019 was reviewed.A total of 208 patients whose PCT and CRP levels were detected within 24 h of fever were selected as the study objects,and they were divided into 178 infected patients and 30 non-infected patients according to etiology,imaging,symptoms,signs and treatment effect.SPSS17.0 software was used for statistical analysis.Results The positive rates of PCT and CRP in the infected patients were higher than those in the non-infected patients(67.4%vs.10.0%,91.6%vs.46.4%,P<0.05).The infection rates of PCT and CRP in double-positive,single-positive and double-negative patients were 98.2%,81.3%and 36.4%,respectively.The infection rates of double-positive patients were higher than those in single-positive patients,and single-positive patients were higher than double-negative patients,and the differences were statistically significant(P<0.05).The infection rates of PCT and CRP positive patients were 97.6%and 92.2%,respectively,which were higher than those in negative patients(68.2%and 48.3%,P<0.05),and the risks of infection in positive patients were 18.6 and 12.6 times higher than those in negative patients.The positive rates of PCT and CRP were consistent with the infection rates,but the coincidence degree was not high(Kappa=0.326 and 0.445,P<0.05).Conclusion The positive test results,especially when PCT is positive or PCT and CRP are both positive,indicating infectious fever.However,the negative results cannot exclude infection completely,which requires comprehensive analysis and careful diagnosis.

关 键 词：恶性肿瘤 发热 降钙素原 C反应蛋白 感染 

分 类 号：R730.43[医药卫生—肿瘤]