hs-CRP与PCT对急性淋巴细胞白血病感染的诊断评价

Diagnosis value of high sensitivity C-reactive protein and calcitonin in acute lymphoblastic leukemia

目的探究超敏C-反应蛋白(hs-CPR)及降钙素原(PCT)在急性淋巴细胞白血病感染的诊断价值。方法选取2015年1月-2016年12月医院血液科收治的完全缓解后进行定期化疗的急性淋巴细胞白血病(acute lymphoblastic leukemia,ALL)患者126例为研究对象,按照是否发生白细胞数量减少且出现感染症状,分为感染组68例和非感染组58例,另选取同期于医院进行体检的健康志愿者20名为对照组。比较非感染组与感染组患者感染初期及对照组的血清hs-CRP和PCT的含量;根据检测结果比较hs-CRP和PCT单独检测及联合检测对ALL患者合并感染的检测阳性率、灵敏度、特异性和准确率,并计算阳性预测率及阴性预测率。结果与未感染组相比较,感染组患者在感染初期,血清中hs-CRP和PCT的含量升高(P<0.05);恢复期hs-CRP和PCT的含量较感染初期降低(P<0.05);感染组患者感染初期的血清hs-CRP和PCT分别为(23.74±3.51)mg/L、(1.96±0.54)ng/ml高于非感染组和对照组P<0.05);对照组和非感染组血清hs-CRP和PCT差异无统计学意义;联合检测hs-CRP和PCT对ALL合并感染的检出率高达89.71%,高于hs-CRP和PCT的单独检测;hs-CRP检测ALL合并感染的灵敏性、特异度、准确率及阴性检测率高于PCT;两项联合检测的灵敏度、准确性、阳性预测率及阴性预测率高于单独检测。结论 ALL合并感染的患者血清中hs-CRP和PCT的含量升高,且两项指标联合检测优于单独检测,具有一定的临床价值。

OBJECTIVE To investigate the diagnosis value of high sensitivity C-reactive protein and calcitonin in acute lymphoblastic leukemia.METHODS A total of 126 patients with acute lymphoblastic leukemia who underwent periodic chemotherapy after complete remission from Jan. 2015 to Dec. 2016 in the hematology department of our hospital were enrolled.According to whether the number of leukocytes decreased and infection symptoms appeared,68 cases were included in the infected group and 58 cases were included in the non-infected group.And another twenty healthy adults were enrolled in this study.The levels of serum hs-CRP and PCT in non-infected and control group were measured and compared with those in the early stage of infection.The positive rate,sensitivity,specificity and accuracy of hs-CRP and PCT detection and combined detection were compared according to the test results,and the positive predictive rate and negative predictive rate were calculated.RESULTS The levels of hsCRP and PCT in the recovery period were significantly lower than those in the early stages of infection（P〈0.05）.Serum hs-CRP and PCT of the infected group at the initial stage of infection were respectively（23.74±3.51）mg/L and（1.96±0.54）ng/ml,significantly higher than those of the non-infected group and control group（P〈0.05）.The difference in serum hs-crp and PCT levels between the non-infected group and the control group was not significant.The detection rate of hs-CRP and PCT for ALL infection was 89.71%,which was significantly higher than that of hs-CRP and PCT alone.The sensitivity,specificity,accuracy and negative detection rate of hsCRP in ALL infection were higher than those in PCT.The specificity and positive detection rate of PCT detection were higher than that of hs-CRP alone.The sensitivity,accuracy,positive predictive rate and negative predictive rate of the two combined detection were higher than those of the single tests.CONCLUSION The levels of serum hs-CRP and PCT in patients with ALL infection were significantly increased,and the combined detection of the two indexes was better than single tests,showing significant clinical value in ALL infection.