血清CRP、PCT及ANA对白血病化疗所致败血症的诊断效能分析

Diagnostic efficacy of serum CRP,PCT and ANA in leukemia chemotherapy-induced sepsis

目的:探究血清C反应蛋白(CRP)、降钙素原(PCT)和抗核抗体(ANA)检测对白血病化疗所致败血症的诊断效能。方法:选取2019年2月—2020年2月接受化疗的白血病患者124例,根据是否并发败血症将患者分为感染组(并发败血症)41例和非感染组(未并发败血症)83例。比较2组患者不同时间点的血清CRP、PCT水平和ANA阳性率,采用受试者工作特征曲线(ROC)分析CRP、PCT、ANA及联合检测对白血病化疗所致败血症的诊断效能。结果:化疗时,2组患者的血清CRP、PCT水平和ANA阳性率比较差异无统计学意义(P>0.05);感染组患者感染后和感染控制后的血清CRP、PCT水平和ANA阳性率均高于化疗时(P<0.05);非感染组患者化疗时的血清CRP、PCT水平和ANA阳性率均明显低于感染组感染后和感染控制后(P<0.05);ROC曲线分析结果显示,CRP、PCT、ANA及联合检测的曲线下面积(AUC)分别为0.786、0.780、0.797和0.874,对白血病化疗所致败血症的诊断均差异有统计学意义(P<0.05),且联合检测的AUC大于各单项检测(P<0.05),联合检测的敏感度和特异度均高于单独检测。结论:白血病化疗后并发败血症患者,其血清CRP、PCT水平和ANA阳性率均高于非感染患者,血清CRP、PCT及ANA对白血病化疗所致败血症有良好的诊断效能,三者联合检测可进一步提高诊断敏感性和特异性。

Objective:To explore the diagnostic efficacy of serum C-reactive protein(CRP),procalcitonin(PCT)and antinuclear antibody(ANA)in leukemia chemotherapy-induced sepsis.Methods:Between February 2019 and February 2020,124 leukemia patients who received chemotherapy in our hospital were enrolled in this study.They were divided into infected group(41 cases with sepsis),and uninfected group(83 cases without sepsis).Serum CRP and PCT levels and ANA positive rates in the 2 groups at different time points were comparatively analyzed.The receiver operating characteristic(ROC)curve was used to analyze the diagnostic efficacy of CRP,PCT,ANA and combination of the three in leukemia chemotherapy-induced sepsis.Results:During chemotherapy,no significant differences were found in serum CRP and PCT levels and ANA positive rate between the 2 groups(P>0.05).The infected group had higher serum CRP and PCT levels and ANA positive rate after infection and infection control than during chemotherapy(P<0.05).Besides,serum CRP and PCT levels and ANA positive rate were significantly lower in uninfected patients during chemotherapy than those in the infected group after infection and after infection control(P<0.05).ROC curve analysis showed that AUC values of CRP,PCT,ANA and combined detection of the three were 0.786,0.780,0.797 and 0.874(P<0.05),showing that the area under curve value of combined detection was greater than that of single test(P<0.05).Also,the sensitivity and specificity of combined detection were higher than those of single detection.Conclusion:Patients with leukemia chemotherapy-induced sepsis had higher serum CRP,PCT and ANA positive rate than uninfected patients.This study showed that serum CRP,PCT and ANA might have good diagnostic efficacy for leukemia chemotherapy-induced sepsis,and combined detection of the three could further improve the diagnostic sensitivity and specificity.