肝素结合蛋白与降钙素原在重症胰腺炎继发细菌感染患者中的诊断价值

Diagnostic value of heparin-binding protein and PCT in diagnosing secondary bacterial infection of patients with severe acute pancreatitis

目的探讨肝素结合蛋白(HBP)和降钙素原(PCT)在重症胰腺炎继发细菌感染患者中的诊断价值。方法选择本院重症医学科2013年12月-2017年12月收治的重症胰腺炎患者142例,根据有无继发细菌感染,分为SAP未继发细菌感染组74例,SAP继发细菌感染组68例,检测各组患者血中的HBP和PCT水平,分析两指标的临床应用价值。结果 SAP继发细菌感染组患者血中HBP和PCT水平明显高于SAP未继发细菌感染组(P<0.05);HBP的ROC曲线下面积为0.93(95%CI:0.90～0.93),当以17.02 mg/L为最佳截断值时,敏感度为84.0%,特异度为87.0%;PCT的ROC曲线下面积为0.80(95%CI:0.73～0.87),当以0.87 mg/L为最佳截断值时,敏感度为66.2%,特异度为81.0%。在SAP继发细菌感染患者中HBP与PCT呈正相关性(r=0.71,P<0.01)。结论 HBP和PCT皆可作为SAP继发细菌感染的检测指标,与PCT变化水平相比,HBP水平升高更明显,更有利于评估SAP继发细菌感染。

Objective To study the diagnostic value of heparin-binding protein(HBP)and procalcitonin(PCT)in observing secondary bacterial infection and acute pancreatitis(SAP).Methods From December 2013 to December 2017 ,142 patients with SAP in our hospital were selected as the research objects,and according to whether suffering from secondary bacterial infection ,the patients were divided into SAP without secondary infection group(74 cases)and SAP with secondary infection group(68 cases).The levels of HBP and PCT in each group were detected,and the clinical value of the two indexes was analyzed.Results The plasma level of HBP and PCT were significantly higher in SAP patients with secondary bacterial infection than those in SAP patients without secondary bacterial infection(P<0.05).The area under the ROC curve of HBP was 0.93(95% CI: 0.90-0.93).With the concentration of 17.02 mg/L being set as the cut-off point,the sensitivity was 84.0%,the specificity was 87.0%,AUC of ROC was 0.80(95% CI :0.73-0.87).When 0.87 mg/L was the cut-off point,the sensitivity was 66.2% and the specificity was 81.0%.HBP was positively correlated with PCT in SAP patients with secondary bacterial infection(r =0.71 ,P<0.01).Conclusion HBP and PCT can be used as the indicators for detecting secondary bacterial infection in SAP,compared with PCT,HBP level increased more obviously,and it was more helpful to evaluate the bacterial infection in SAP.