淋巴细胞比值、C 反应蛋白及血清降钙素原在系统性红斑狼疮合并细菌感染病人早期诊断中的应用

Application of NLCR,PCT and CRP in early diagnosis of patients with systemic lupus erythematosus complicated with bacterial infection

目的探讨淋巴细胞比值(NLCR)、C反应蛋白(CRP)及血清降钙素原(PCT)在系统性红斑狼疮(SLE)合并细菌感染病人早期诊断中的应用。方法纳入2017年3月至2019年8月安庆市立医院收治的92例SLE病人的临床资料,将病例依据是否合并细菌感染分为SLE合并细菌感染组49例和SLE未合并细菌感染组43例。记录所有病人的性别、年龄、主诉、系统受累程度等一般资料,检测中性粒细胞、淋巴细胞数量、PCT及CRP水平。结果SLE合并细菌感染组病人的肾炎、雷诺综合征发生率、NLCR(6.12±2.84)、PCT(1.92±1.56)μg/L及CRP(31.69±18.25)mg/L水平均高于SLE未合并细菌感染组病人[NLCR(4.42±2.28)、PCT(0.25±0.33)μg/L及CRP(17.45±11.58)mg/L],均差异有统计学意义(P<0.05)。经Pearson相关性检验,结果显示,NL⁃CR、CRP与PCT均呈低度正相关(r=0.219,P=0.035;r=0.231,P=0.027)。NLCR、PCT及CRP诊断SLE合并细菌感染的ROC曲线结果显示,NLCR、PCT、CRP及三者联合的AUC分别为:0.682、0.869、0.740、0.934;同时,三指标联合显著高于各单一指标。结论NLCR、CRP与PCT均可用于SLE合并细菌感染病人早期诊断,且三指标联合检测可大大提高诊断价值。

Objective To explore application of neutrophil-to-lymphocyte ratio(NLCR),C-reactive protein(CRP)and serum procal⁃citonin(PCT)in early diagnosis of patients with systemic lupus erythematosus(SLE)complicated with bacterial infection.Methods The clinical data of 92 SLE patients who were admitted to the Anqing Municipal hospital from March 2017 to August 2019 were en⁃rolled.According to whether they were associated with bacterial infection,they were divided into SLE with bacterial infection group(n=49)and SLE without bacterial infection group(n=43).General data such as gender,age,main complaints and system involvement of all patients were recorded.The number of neutrophils and lymphocytes,levels of PCT and and CRP were detected.Results The inci⁃dence of nephritis and Raynaud's syndrome,NLCR(6.12±2.84),levels of PCT(1.92±1.56)μg/L and CRP(31.69±18.25)mg/L in SLE with bacterial infection group were higher than those in SLE without bacterial infection group[NLCR(4.42±2.28),levels of PCT(0.25±0.33)μg/L and CRP(17.45±11.58)mg/L](P<0.05).The results of Pearson correlation test showed that the NLCR and CRP were slightly positively correlated with PCT(r=0.219,P=0.035;r=0.231,P=0.027).The results of ROC curves of NLCR,PCT and CRP for diagnosis of SLE combined with bacterial infection showed that AUC of NLCR,PCT,CRP and their combination were 0.682,0.869,0.740 and 0.934,respectively.Meanwhile,combination of the three indexes was significantly higher than single index.Conclusion NLCR,CRP and PCT all can be applied in early diagnosis of patients with SLE combined with bacterial infection.And the combined detection of the three indicators can greatly improve diagnostic value.