两种血清标志物检测在系统性红斑狼疮合并发热的临床价值

The clinical value of two serum markers detection systemic lupus erythematosus with fever

目的探讨降钙素原(PCT)及C反应蛋白(CRP)检测在系统性红斑狼疮(SLE)合并发热患者中的价值。方法回顾性分析52例SLE伴发热的患者,并与15例单纯感染患者对照,将其分为SLE合并感染组(22例)、单纯SLE组(30例)及单纯感染组(15例),比较三组PCT、CRP水平以及比较SLE合并感染组治疗前后PCT、CRP水平,并分析SLE患者中PCT、CRP与狼疮活动指标的关系,比较PCT、CRP单独及联合检测在诊断SLE合并感染的特异性及敏感性。结果 SLE合并感染组PCT、CRP水平显著高于单纯SLE组;单纯感染组PCT及CRP与SLE合并感染组比较无显著性差异,但与单纯SLE组之间比较差异有统计学意义;两SLE组不同活动度间PCT及CRP水平比较无显著性差异;PCT的特异性及敏感性均较CRP高,但差异均无统计学意义;PCT与CRP联合检测的特异性及敏感性明显高于单独检测CRP,和单独检测PCT比较,特异性明显提高,但敏感性无明显差异。结论 PCT、CRP浓度在多数SLE合并感染患者中升高,对于鉴别狼疮感染与活动有一定临床价值,两者联合检测更可提高临床诊断价值。

Objective To evaluate the clinical diagnosis value of procalcitonin（PCT）and C-reactive protein（CRP）in patients of systemic lupus erythematosus （SLE） with fever. Methods Prospectively selected 52 cases of SLE patients with fever,and contrast to 15 patients of simple infection group,enrolled SLE with infection group（22 cases）,simple SLE group （30 cases） and simple infection group（15 cases）. Three groups of PCT and CRP levels, compared PCT and CRP levels of SLE with infection before and after treatment, and the relationship between PCT and CRP and lu-pus activity indicators in SLE patients were analyzed. The sensitivity and specificity with the separate and combined detection PCT and CRP levels for the diagnosis of SLE with infection were compared. Results The PCT and CRP levels of SLE with infection were significantly higher than the levels of simple SLE group.The PCT and CRP levels of simple infection group had no statistical difference between SLE with infection group,but the difference between simple SLE group was statistically significant. In two SLE group with different activity PCT and CRP levels had no significant dif-ference. The sensitivity and specificity of PCT compared with CRP was higher,but the difference had no statistically significant. The sensitivity and specificity in PCT and CRP combined detection were higher than separate detection CRP. Compared with separate detection PCT,the sensitivity was not significant difference,but specificity significantly increased. Conclusion The levels of PCT and CRP increase in most SLE patients with infectiont, detecting PCT and CRP is useful to distinguish infection and lupus activity,the combined detection can improve the diagnostic value.