联合模式分析肝素结合蛋白与中性粒细胞绝对值在血液系统疾病早期感染的临床应用  

Clinical application of heparin-binding protein and absolute neutrophil values in early infection of hematologic diseases

作　　者：邢海洲[1] 梁春艳 徐新童 李俏俏 李英梅[1] XING Hai-zhou;LIANG Chun-yan;XU Xin-tong;LI Qiao-qiao;LI Ying-mei(Department of Hematology,First Affiliated Hospital of Zhengzhou University,Zhengzhou,450052,China)

机构地区：[1]郑州大学第一附属医院血液科,郑州450052

出　　处：《医药论坛杂志》2023年第17期53-57,共5页Journal of Medical Forum

基　　金：国家自然科学基金资助项目资助(U1804192、U1504810)。

摘　　要：目的 探讨肝素结合蛋白(Heparin binding protein, HBP)在血液系统疾病早期感染中的恰当解读的正确模式,寻找早期判断感染的新模式。方法 回顾性分析2021年3月至8月在郑州大学第一附属医院接受治疗的90例血液系统疾病患者的病例资料。所有患者分为感染组与非感染组,检测血常规、C反应蛋白(C-Reactive Protein, CRP)、降钙素原(Procalcitonin, PCT)、肝素结合蛋白,比较两组资料的差异。根据白细胞数目进一步分成白细胞细胞正常组、白细胞细胞减少组、中性粒细胞缺乏组,比较在不同中性粒细胞数目下感染组与非感染组在CRP、PCT、HBP中的差异。进一步分析HBP与中性粒细胞数目的关系,比较“肝素结合蛋白/中性粒细胞”在感染组与非感染组的差异。结果 感染组CRP、PCT、HBP水平均明显高于非感染组;白细胞数目正常时,HBP在AUC数值上高于CRP、PCT;HBP受中性粒细胞数目的影响,HBP水平与中性粒细胞数目呈正相关(r=0.706,P<0.05);“肝素结合蛋白/中性粒细胞”比值不受中性粒细胞数目影响,“肝素结合蛋白/中性粒细胞”比值在感染组明显高于非感染组。结论 HBP水平受中性粒细胞数目影响,当中性粒细胞数目正常时,HBP在判断早期感染的价值上优于CRP、PCT,当中性粒细胞数目减少甚至缺乏时“肝素结合蛋白/中性粒细胞”比值反应感染更具有意义。HBP作为感染指标用于血液系统疾病感染时,应结合中性粒细胞数目进行综合评价。Objective To explore the correct pattern of proper interpretation of heparin binding protein(HBP)in the early infection of hematological diseases,and to search for a new pattern of early diagnosis of infection.Methods A retrospective analysis of the data of 90 patients with hematological diseases treated in our hospital from March to August 2021.All patients were divided into infection group and non-infection group.Blood routine,C-Reactive Protein(CRP),Procalcitonin(PCT),and HBP were tested to compare the differences between the two groups.It was further divided into leukocytes normal group,leukopenia group and agranulocytosis group according to the number of leukocytes,and the level of CRP,PCT and HBP between the infection group and the non-infection group were compared under the different number of leukocytes.The relationship between HBP and neutrophils was further analyzed,and the ratio HBP to neutrophils between the infection group and the non-infection group was compared.Results The levels of CRP,PCT,and HBP were significantly higher in the infection group than in the non-infection group.When the number of leukocytes were in the normal range,the AUC of HBP was higher than that of CRP and PCT.The level of HBP was affected by the number of neutrophils,and was positively correlated.The ratio HBP to neutrophils was not affected by the number of neutrophils,and the ratio was significantly higher in the infection group.Conclusion HBP is affected by the number of neutrophils,and is superior to CRP and PCT in the diagnosis of early infection when the number of neutrophils is within the normal range,but the ratio HBP to neutrophil is more meaningful in reflecting infection in the condition of leukopenia or agranulocytosis.HBP should be comprehensively analysis in combination with the number of neutrophils when it is used as an indicator of infection in hematological diseases.

关 键 词：肝素结合蛋白 中性粒细胞 早期诊断 血液病 

分 类 号：R574[医药卫生—消化系统]