CRP、PCT、ILG6、外周血WBC及凝血功能指标联合检测在急性白血病合并脓毒性休克中的临床价值  

The clinical value of combined detection of CRP,PCT,IL-6,peripheral blood WBC and coagulation function indexes in acute leukemia complicated with septic shock

作　　者：龙江文 廖楚舒 冯珊[1] 雷平[1] Long Jiangwen;Liao Chushu;Feng Shan;Lei Ping(Department of Blood Transfusion,Laboratory of Hematology,Hunan Provincial People's Hospital(The First Affiliated Hospital of Hunan Normal University),Changsha,China)

机构地区：[1]湖南省人民医院(湖南师范大学附属第一医院)输血科血液病实验室

出　　处：《实用休克杂志(中英文)》2024年第5期277-281,285,共6页Journal of Practical Shock

摘　　要：目的分析C反应蛋白(CRP)、降钙素原(PCT)、白细胞介素6(IL-6)和外周血白细胞(WBC)及凝血功能指标对预测急性白血病合并脓毒性休克的临床价值。方法回顾性分析2021年5月至2023年5月本院收治的89例急性白血病患者,根据感染程度分为脓毒性休克组32例、普通感染组29例、未感染组28例。均采集患者空腹静脉血液,检测患者血清CRP、PCT、IL-6水平、外周血WBC计数和凝血功能指标,比较脓毒性休克组、普通感染组和未感染组之间的各项指标差异。结果脓毒性休克组患者的血清WBC、CRP、PCT、IL-6水平和凝血功能指标均明显高于普通感染组和未感染组,且普通感染组患者的血清WBC、CRP、PCT、IL-6水平和凝血功能指标也明显高于未感染组,差异有统计学意义(P<0.05)。Pearson分析结果显示,脓毒性休克组的血清WBC、CRP、PCT和IL-6及凝血功能指标之间均未呈现出正相关性(P>0.05)。ROC曲线分析结果表明:CRP的ROC下面积(曲线AUC)为0.995(95%CI:0.9852~1.000,P<0.05),PCT的AUC=0.974(95%CI:0.9399~1.000,P<0.05),IL-6的AUC=0.980(95%CI:0.9437~1.000,P<0.05)。三者联合的曲线下面积高于每项单独检测指标(AUC=1.000,95%CI:1.000~1.000,P<0.05)。结论CRP、PCT、IL-6、外周血WBC及凝血功能指标的检测在急性白血病合并脓毒性休克中的变化显著,对临床诊断有重要的指导意义。Objective To analyze the clinical value of C-reactive protein(CRP),procalcitonin(PCT),interleukin-6(IL-6)and peripheral white blood cells(WBC)and coagulation function detection in predicting acute leukemia complicated with septic shock.Methods A retrospective analysis was performed on 89 patients with acute leukemia admitted to our hospital from May 2021 to May 2023.They were divided into septic shock group(32 cases),common infection group(29 cases)and uninfected group(28 cases)according to whether they were infected or not.Fasting venous blood was collected from all patients,and serum CRP,PCT,IL-6,peripheral blood WBC count and coagulation function indexes were detected.The differences of various indexes among septic shock group,common infection group and uninfected group were compared.Results The serum levels of WBC,CRP,PCT,IL-6 and coagulation function indexes in the infected shock group were significantly higher than those in the common infected group and the uninfected group,and the serum levels of WBC,CRP,PCT,IL-6 and coagulation function indexes in the common infected group were also significantly higher than those in the uninfected group(P<0.05).The results of Pearson correlation analysis showed that serum WBC,CRP,PCT,IL-6 and coagulation function indexes in the infected shock group were not positively correlated(P>0.05).According to the ROC curve analysis,the area under the ROC curve(AUC)of CRP is 0.995(95%CI:0.9852~1.000,P<0.05),the AUC of PCT is 0.974(95%CI:0.9399~1.000,P<0.05),the AUC of IL-6 is 0.980(95%CI:0.9437~1.000,P<0.05).The area under the curve of the combination of the three indicators was higher than that of each individual indicator(AUC=1.000,95%CI:1.000~1.000,P<0.05).Conclusions The detection of CRP,PCT,IL-6,peripheral blood WBC and coagulation function indexes in acute leukemia complicated with septic shock has significant changes,which has important guiding significance for clinical diagnosis.

关 键 词：急性白血病 脓毒性休克 外周血白细胞 凝血功能 

分 类 号：R459.7[医药卫生—急诊医学] R733.71[医药卫生—治疗学]