肝素结合蛋白在矽肺并发重症感染患者中的诊断价值

Diagnostic value of heparin-binding protein in patients with silicosis complicated by severe infection

目的探讨肝素结合蛋白(HBP)在矽肺患者并发重症感染诊断中的应用价值.方法选取2017年1月至2018年3月徐州矿务集团总医院尘肺科矽肺患者150例,其中矽肺重症感染组100例,矽肺非感染组50例;选择同期健康体检者30例为对照组.所有入组人员均进行HBP、C反应蛋白(CRP)、降钙素原(PCT)以及白细胞计数(WBC)、中性粒细胞百分比、中性粒细胞绝对值等相关炎性指标水平检测,使用受试者工作特征曲线(ROC)分析其对不同分期矽肺重症感染组患者的诊断效能(曲线下面积,AUC),对HBP和其他指标进行相关性分析.结果矽肺重症感染组患者血浆中HBP水平[(50.39±35.64)ng/ml]明显高于矽肺非感染组[(10.71±1.47)ng/ml]和对照组[(9.24±1.83)ng/ml](P<0.05),且随着矽肺分期增高呈递增趋势(P<0.05).ROC分析显示,HBP在壹、贰、叁期矽肺重症感染组患者中AUC分别为0.932、0.977、0.964,均高于WBC、CRP、PCT等指标;相关性分析显示,HBP与WBC、CRP、PCT均呈正相关(r=0.711、0.359、0.729,P<0.01).结论HBP在矽肺并发重症感染患者中具有较高的诊断效能,可能成为矽肺患者重症感染的临床筛查指标及矽肺患者病程分期的辅助检查指标.

Objective To explore the application value of heparin binding protein(HBP)in the diagnosis of severe infection in patients with silicosis.Methods A prospective study was conducted on 150 patients with silicosis in the pneumoconiosis department of the General Hospital of Xuzhou Mining Group from January 2017 to March 2018.Among them,100 were severely infected with silicosis and 50 were non-infected with silicosis.30 patients were selected in the same period of physical examination as the control group.HBP,C-reactive protein(CRP),procalcitonin(PCT),white blood cell count(WBC),neutrophil percentage,and absolute neutrophil count(ANC)were detected in all participants.Using the receiver operating characteristic curve(ROC)to analyze the diagnostic value of indicator above in patients with different stages of severe silicosis infection.Results Plasma HBP levels in patients with severely infected silicosis group[(50.39±35.64)ng/ml]were higher than those in the non-infected group[(10.71±1.47)ng/ml]and the control group[(9.24±1.83)ng/ml](P<0.05),and with the increase of silicosis stages,there is an increasing trend(P<0.05).The ROC curve showed that the AUC of HBP in the patients with severe silicosis in the first,second,and third stages were 0.932,0.977,and 0.964,which were higher than those of WBC,CRP,and PCT.Correlation analysis showed that HBP was positively correlated with WBC,CRP and PCT(r=0.711,0.359,0.729,P<0.01).Conclusion HBP has high diagnostic efficacy in the diagnosis of severe infections in patients with silicosis,which may become a clinical screening indicator for severe infections in patients with silicosis and an auxiliary examination indicator for the stage of silicosis patients.