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目的研究血清超敏C-反应蛋白(hs-CRP)、降钙素原(PCT)和内毒素(ET)在白血病患者化疗后并发感染应用价值。方法选取2013年11月-2016月10月医院白血病化疗患者170例,其中化疗后并发感染98例设为感染组,非感染患者72例设为非感染组,同期再选取健康体检者50例作对照组,检测感染患者化疗时、感染时、感染控制后和完全缓解后以及非感染患者化疗期间、健康体检人群入选时血清hs-CRP、PCT、ET水平。结果感染组hs-CRP、PCT、ET水平感染时、感染控制后高于化疗时,差异有统计学意义(P<0.05),感染控制后、完全缓解后水平低于感染时,完全缓解后水平低于感染控制后,差异有统计学意义(P<0.05);非感染组、对照组hs-CRP、PCT、ET水平低于感染组感染时、感染控制后,差异有统计学意义(P<0.05);PCT曲线下面积(AUC)0.940,高于hs-CRP、ET,差异有统计学意义(P<0.05);PCT截断值0.745ng/mL,特异性91.67%、敏感度87.76%。结论血清PCT、hs-CRP、ET水平检测在临床诊断白血病化疗后感染中具有一定价值且有助于病情评估、指导临床治疗,尤其PCT具有较高诊断敏感度与特异性,而联合检测有助于提高白血病化疗后并发感染诊断准确率。
Objective To investigate the value of serum hs-CRP, PCT and ET in patients with leukemia after chemotherapy. Methods A total of 170 hospitalized patients with leukemia from November 2013 to October 2016 were selected. Among them, 98 cases were infected with chemotherapy after infection, 72 cases were non-infected with non-infected patients, and 50 cases were selected as healthy subjects during the same period In the control group, serum hs-CRP, PCT and ET levels were measured at the time of chemotherapy, infection, infection control and after complete remission, as well as non-infected patients during chemotherapy. Results The levels of hs-CRP, PCT and ET in infected group were significantly higher than those in chemotherapy after infection (P <0.05). After infection control, the levels after complete remission were lower than those after infection (P <0.05). The levels of hs-CRP, PCT and ET in non-infected group and control group were lower than those in control group after infection control (P <0.05), the difference was statistically significant (P < 0.05). The area under the curve of PCT (AUC) was 0.940 higher than that of hs-CRP and ET (P <0.05). The PCT cutoff was 0.745ng / mL, specificity was 91.67% and the sensitivity was 87.76%. Conclusion The detection of serum PCT, hs-CRP and ET levels has some value in post-chemotherapy infection of clinical diagnosis of leukemia, which is helpful to evaluate the disease and guide the clinical treatment. In particular, PCT has higher diagnostic sensitivity and specificity, and combined detection is helpful To improve the diagnosis of leukemia complicated with infection after chemotherapy accuracy.