3项检测在感染性炎症与系统性红斑狼疮中的诊断价值

The value of the united 3 test in diagnosis of infective inflammation and systemic lupus erythematosus

目的探讨血浆降钙素原(PCT)、超敏C-反应蛋白(hs-CRP)与肿瘤坏死因子受体(sTNFR)在细菌感染炎症与活动期系统性红斑狼疮(SLE)鉴别与诊断价值。方法采用自动生化仪与电化学发光仪检测49例临床诊断为细菌性感染的患者与30例非细菌感染者血液中PCT与hs-CRP含量;采用酶联免疫吸附试验检测21例活动期SLE患者与30例静止期SLE患者血液中TNFR浓度。结果细菌感染组与非细菌感染组PCT浓度为(0.178±0.04)、(0.038±0.03)ng/mL,hs-CRP浓度平均秩次为49.2、20.5mg/L(P<0.05),活动期SLE组与静止期SLE组sTNFR1浓度为(12.73±3.94)、(8.54±3.23)ng/mL,sTNFR2浓度为(9.23±2.56)、(6.31±2.04)ng/mL(P<0.05),PCT诊断细菌性感染炎症的ROC曲线下面积为0.719,P=0.013;hs-CRP诊断细菌性感染炎症的ROC曲线下面积为0.852;sTNFR1诊断活动期SLE的ROC曲线下面积为0.792,P=0.000,sTNFR2诊断活动期SLE的ROC曲线下面积为0.834,P=0.000。结论 PCT与hs-CRP检测有助于区分细菌性感染与SLE活动期炎症,hs-CRP诊断细菌性感染的诊断价值高于PCT,sTNFR可以有效区分活动期SLE与静止期SLE。

Objective To investigate the diagnosis value of procalcitonin （PCT ） ,high sensitivity C-reactive protein （hs-CRP） and tumor necrosis factor receptor（TNFR） in patients with systemic lupus erythematosus （SLE） and bacterial infection .Methods The PCT and hs-CRP of blood in 49 cases with bacterial infection and 30 healthy subjects were detected by automatic biochemistry analyzer and the electrochemical luminescence instrument .ELISA was used to detect TNFR concentration of blood in 21 cases of active SLE and 30 cases of bacterial infection patients . Results The concentration of PCT was （0 .178 ± 0 .04） ,（0 .038 ± 0 .03）ng/mL and mean rank of hs-CRP was 49 .2 , 20 .5 mg/L in bacterial infection group and non bacterial infection group （P〈0 .05） .the concentration of sTNFR1 was （12 .73 ± 3 .94） ,（8 .54 ± 3 .23） ng/mL and sTNFR2 was （6 .31 ± 2 .04） ,（9 .23 ± 2 .56）ng/mL in active SLE group and stationary SLE group（P〈0 .05） .The area of PCT and hs-CRP ROC curve were 0 .719 and 0 .852 in diag-nosis bacterial infection .The area of sTNFR1and sTNFR2 ROC curve were 0 .792 and 0 .834 in diagnosis active SLE . Conclusion PCT and hs-CRP could be used to distinguish bacterial infection and active inflammation of SLE ,and the value of hs-CRP might be higher than that of PCT ,meanwhile sTNFR could be used to distinguish the active SLE and resting SLE effectively .