血清降钙素原与C-反应蛋白联合检测对恶性肿瘤患者早期感染诊断的临床价值

The clinical value of combined detection of serum procalcitonin and C-reactive protein in the diagnosis of early infection in patients with malignant tumor

目的探讨血清降钙素原(Procalcitonin,PCT)与C-反应蛋白(C-reactive protein,CRP)检测在恶性肿瘤患者早期感染诊断中的价值。方法选取2014年3月-2015年3月南京医科大学第一附属医院收治的158例确诊恶性肿瘤患者,根据患者是否发生感染及培养结果分为感染组124例(细菌感染96例、非细菌感染28例)和未感染组34例。分别采用荧光素增强免疫化学发光法和免疫散射比浊法检测各组患者血清中的PCT、CRP并分析各组肿瘤患者PCT与CRP的差异。结果细菌感染组、非细菌感染组及未感染组PCT均值分别为(28.44±15.21)ng/ml、(0.68±0.25)ng/ml、(0.45±0.26)ng/ml;CRP均值分别为(66.61±22.23)mg/L、(28.37±9.58)mg/L、(7.81±3.65)mg/L;各组数据间比较差异均有统计学意义(P<0.05)。感染组中细菌感染组患者的PCT、CRP的阳性率为85.42%、87.50%,两者联合检测阳性率(即任一指标为阳性)为90.60%;非细菌感染组患者PCT、CRP的阳性率为25.00%、42.86%,两者联合检测阳性率为46.43%;未感染组患者PCT、CRP的阳性率分别为14.71%、32.35%,两者联合检测阳性率为35.43%;各组数据间比较差异有统计学意义(P<0.05)。结论 PCT与CRP皆为恶性肿瘤患者早期感染的重要指标,两者联合检测提高了恶性肿瘤患者早期感染的检出率,可作为快速筛查和诊断恶性肿瘤患者感染的重要检测手段,对恶性肿瘤患者感染的早期诊断、鉴别具有非常重要的临床应用价值。

Objective To explore the value of procalcitonin and C-reactive protein level in the early diagnosis of infections in patients with malignant tumor.Methods A total of 158 patients with malignant tumor,who were admitted to the first affiliated hospital of Nanjing Medical University during Mar 2014 to Mar 2015,were divided into two groups.124 malignant tumor patients complicated with infections（96cases of bacterial infection,28 cases of non-bacterial infections）were assigned as the infected group,while 34 tumor patients without any infections were set as the uninfected group.PCT and CRP levels were detected by fluorescein enhance immunochemiluminescence and immune scatter turbidimetry,respectively.And the difference between PCT and CRP was analysed among these groups.ResultsThe levels of PCT and CRP in bacterial infection group were（28.44±15.21）ng/ml and（66.61±22.23）mg/L respectively and（0.68±0.25）ng/ml,（28.37±9.58）mg/L in non-bacterial infection patients as well as（0.45±0.26）ng/ml,（7.81±3.65）mg/L in uninfected controls.There were statistically significant differences in the groups（P〈0.05）.The positive ratios of PCT results and CRP levels in bacterial infection group were 85.42%,87.50%,respectively.The combined determination of total positive rate（either indicator is positive）was 90.60%.The positive ratios of PCT results and CRP levels in non-bacterial infection group were 25.00%,42.86%,respectively.The total positive rate was 46.43%.The positive ratios of PCT results and CRP levels in uninfected group were14.71%,32.35%,respectively.The total positive rate of combined determination was 35.43%.There were statistically significant differences in the groups（P〈0.05）.Conclusion The detection of both PCT and CRP are conducive to the early diagnosis of infection in malignant tumor patients.The combined use of them is worthy to the diagnosis,and antidiastole of the disease.