HNL、PCT、TRAIL对血液病患者血流感染的诊断价值  

Diagnostic roles of HNL,PCT and TRAIL in bloodstream infection of patients with hematological diseases

作　　者：刘瑞来[1] 商安全 关明[1] LIU Ruilai;SHANG Anquan;GUAN Ming(Department of Clinical Laboratory,Huashan Hospital,Fudan University,Shanghai 200040,China;Department of Clinical Laboratory,Tongji Hospital,Tongji University,Shanghai 200065,China)

机构地区：[1]复旦大学附属华山医院检验科,上海200040 [2]同济大学附属同济医院检验科,上海200065

出　　处：《检验医学》2020年第12期1277-1280,共4页Laboratory Medicine

摘　　要：目的探讨人中性粒细胞载脂蛋白(HNL)、降钙素原(PCT)、肿瘤坏死因子相关凋亡诱导配体(TRAIL)在诊断血液病患者血流感染中的价值。方法选取血培养阳性的血液病患者(血流感染组)和血培养阴性的血液病患者(非血流感染组)各120例,检测所有患者的HNL、PCT、TRAIL水平。采用受试者工作特征(ROC)曲线评价各项指标诊断血流感染的效能。结果血流感染组HNL、PCT水平显著高于非血流感染组(P<0.0001),TRAIL水平显著低于非血流感染组(P<0.0001)。采用Logistic回归分析建立HNL、PCT和TRAIL的联合检测模型。ROC曲线分析结果显示,HNL、PCT、TRAIL及联合检测模型诊断血流感染的ROC曲线下面积(AUC)分别为0.993、0.849、0.938、0.996,最佳临界值分别为60.15 ng/mL、0.85 ng/mL、104.57 pg/mL、0.34,敏感性分别为100%、61.7%、90.8%、100%,特异性分别为97.5%、91.7%、84.2%、98.4%。结论HNL、PCT、TRAIL诊断血液病患者血流感染有较好的价值。Objective To evaluate the diagnostic roles of human neutrophil lipocalin(HNL),procalcitonin(PCT)and tumour necrosis factor-related apoptosis-inducing ligand(TRAIL)in patients with hematological diseases.Methods A total of 120 blood culture-positive hematologic patients(blood stream infection group)and 120 blood culture-negative hematologic patients(non-blood stream infection group)were enrolled,and the levels of HNL,PCT and TRAIL were determined.The efficiency of each index in diagnosing blood stream infection was evaluated by receiver operating characteristic(ROC)curve.Results The levels of HNL and PCT were higher in bloodstream infection group than those in non-bloodstream infection group(P<0.0001),and the level of TRAIL was lower than that in non-bloodstream infection group(P<0.0001).Logistic regression analysis was used to list the combined determination models of HNL,PCT and TRAIL,and ROC curve analysis showed that the AUC of HNL,PCT,TRAIL and the combined determination models for blood stream infection were 0.993,0.849,0.938 and 0.996,respectively,and the optimal cut-off values were 60.15 ng/mL,0.85 ng/mL,104.57 pg/mL,0.34,with the sensitivities of 100%,61.7%,90.8%and 100%and the specificities of 97.5%,91.7%,84.2%and 98.4%,respectively.Conclusions HNL,PCT and TRAIL play roles in the diagnosis of bloodstream infection in hematologic patients.

关 键 词：人中性粒细胞载脂蛋白 降钙素原 肿瘤坏死因子相关凋亡诱导配体 血流感染 

分 类 号：R446.1[医药卫生—诊断学]