支气管扩张合并感染患者血清suPAR、PCT和CRP水平及其临床意义

Serum levels of suPAR,PCT and CRP and their clinical significance in bronchiectasis with infection

目的分析支气管扩张合并感染患者血清可溶性尿激酶型纤溶酶原激活物受体(soluble urokinase-type plasminogen activator receptor,suPAR)、降钙素原(procalcitonin,PCT)和C反应蛋白(C-reactive protein,CRP)水平的检测意义。方法收集2016年5月—2019年5月在广安市人民医院就诊的100例支气管扩张合并感染患者(研究组),根据病情严重程度将其分为轻度(n=23)、中度(n=56)、重度(n=21)3个亚组;将同期30例健康体检者纳入对照组。比较研究组各亚组间及研究组与对照组受试者血清suPAR、PCT、CRP水平差异,应用受试者工作特征曲线(receiver operating characteristic curve,ROC)及曲线下面积(area under curve,AUC)评价suPAR、PCT、CRP及三者联合对支气管扩张合并感染的诊断价值。结果研究组血清suPAR、PCT、CRP水平高于对照组(P<0.05);研究组各亚组间血清suPAR、PCT、CRP水平差异有统计学意义(P<0.05),各指标水平轻度组低于中、重度组,中度组低于重度组(P<0.05);血清suPAR、PCT、CRP水平与受试者是否患支气管扩张合并感染密切相关(P<0.05)。suPAR AUC为0.951(P<0.05),临界值为5.88 ng/m L,敏感性、特异性分别为0.850、1.000;PCT AUC为0.943(P<0.05),临界值为0.13 ng/m L,敏感性、特异性分别为0.860、0.967;CRP AUC为0.921(P<0.05),临界值为5.16 mg/L,敏感性、特异性分别为0.830、0.933;三者联合预测AUC为0.989,敏感度、特异度分别为0.950、1.000,优于各自单独预测(P<0.05)。结论血清suPAR、PCT、CRP水平升高与支气管扩张合并感染发生、发展密切相关,联合检测对支气管扩张合并感染诊断有一定价值。

Objective To analyze the detection significance of serum levels of soluble urokinase-type plasminogen activator receptor(suPAR),procalcitonin(PCT)and C-reactive protein(CRP)in patients with bronchiectasis complicated with infection.Methods The study subjects were 100 patients with bronchiectasis and infection in Guang’an People’s Hospital from May 2016 to May 2019(study group).According to the severity of the disease,they were divided into mild subgroup(n=23),moderate subgroup(n=56)and severe subgroup(n=21).Thirty healthy examiners were included in control group.The serum levels of suPAR,PCT and CRP were compared among the subgroups of study group or between study group and control group.The receiver operating characteristic curve(ROC)and area under curve(AUC)were used to evaluate the diagnostic value of suPAR,PCT,CRP and combination of the three molecutes for bronchiectasis with infection.Results The serum levels of suPAR,PCT and CRP in study group were higher than those in control group(P<0.05).There were statistically significant differences in the levels of serum suPAR,PCT and CRP among the subgroups of study group(P<0.05).The levels of indexes in mild group were lower than those in moderate group and severe group,and the levels in moderate group were lower than those in severe group(P<0.05).Serum levels of suPAR,PCT and CRP were closely related to whether the subjects had bronchiectasis and infection(P<0.05).The AUC of suPAR was 0.951(P<0.05),and the cut-off value,sensitivity and specificity were 5.88 ng/m L,0.850 and 1.000,respectively.The AUC of PCT was 0.943(P<0.05),and the cut-off value,sensitivity and specificity were 0.13 ng/m L,0.860 and 0.967,respectively.The AUC of CRP was 0.921(P<0.05),and the cut-off value,sensitivity and specificity were 5.16 mg/L,0.830 and 0.933,respectively.The AUC of the three combined prediction was 0.989,and the sensitivity and specificity were 0.950 and 1.000,respectively,which were better than those of respective individual predictions(P<0.05).Conclusion The elevated levels of serum suPAR,PCT and CRP are closely related to the occurrence and development of bronchiectasis with infection.Combined detection has certain value in the diagnosis of bronchiectasis with infection.