D-二聚体和CRP、PCT对甲型禽流感病毒患者的诊疗价值研究

The study on the diagnostic value of D-dimer, CRP and PCT in avian influenza patients

目的：探讨D二聚体（D-dimer）、C反应蛋白（C-reactive protein,CRP）、降钙素（Procalcitonin，PCT）对甲型禽流感患者诊断的临床意义。方法：选取2014年3月-2017年4月肇庆市第一人民医院收治的呼吸道感染的患者，分为细菌感染组、甲流感染组、非甲流病毒感染组和健康对照组；回顾性分析以上患者的D-dimer、CRP和PCT表达水平。结果：与对照组对比，3类感染组中D-dimer、CRP及PCT均明显升高（P0．05）；虽然与细菌感染组相比，甲流感染组各项指标均无显著性差异（P〉0．05），但与非甲流病毒感染组对比，其各项指标均明显升高（P〈0．05）。其中，H7N9亚型患者的D-dimer和PCT显著高于H1N1亚型（P〈0．05）；且三种指标水平和D-dimer水平分别与H1N1以及H7N9患者的预后密切相关（P〈0．05）。结论：甲流患者的D-dimer、CRP及PCT的水平有助于其与其它病毒感染相鉴别，且D-dimer和PCT水平有助于临床早期对H7N9和H1N1亚型的鉴别诊断，而三项指标联合及D-dimer单独检测分别可为H1N1和H7N9亚型感染患者病死率提供一定判断依据。

Objective： The present study aims to investigate the diagnostic value of D-dimer, C-reactive protein （CRP） and Procalcitonin （PCT） in patients with avian influenza. Methods： The patients with respiratory tract infection were collected and divided into four groups including bacterial infection, avian influenza infection, non-avian influenza infection and healthy control. The expression levels of D-timer, CRP and PCT were retrospectively analyzed among above four groups. Results： Compared with the control group, D-dime, CRP and PCT levels were significantly increased m other three groups （P〈0.05） . Although compared with the bacterial infection group there was no significant differences in the indexes of avian influenza infection group （P〉0.05） , the levels of D-dimer, CRP and PCT in avian influenza infection group were significantly higher than that in common virus group （P〈0.05） . Furthermore, the levels of D-dimer and PCT in H7N9- infected patients were higher than that in H1N1-infected patients. More importantly, the expression levels of D-dimer, CRP and PCT in H1N1- infected patients and D-dimer in H7N9- infected patients were associated with higher mortality. Oorlc[usi0n： The levels of D-dimer, CRP and PCT could help to differentiate patients with avian influenza infection from other viral infections, and the D-Dimer and PCT levels could help to identify the differential diagnosis of H7N9 and HIN1 subtypes. The co-detection of three indexes and single detection of D-dimer can predicate early death rate for H1N1 and H7N9 subtype infection in patients.