血清降钙素原、超敏C反应蛋白联合检测对急性淋巴细胞白血病患者感染的诊断价值

Diagnostic value of combined detection of serum procalcitonin and highsensitivity C-reactive protein for infection in patients with acute lymphoblastic leukemia

目的探讨血清降钙素原(PCT)、超敏C反应蛋白(hs-CRP)联合检测对急性淋巴细胞白血病(ALL)患者感染的诊断价值。方法选取204例ALL患者,均接受病原学检查,依据检查结果分为感染组和对照组,比较两组患者的血清PCT、hs-CRP水平。以病原学检查结果为金标准,评估PCT、hs-CRP单独及联合检测对ALL患者感染的诊断价值。结果病原学检查结果显示,204例ALL患者中,合并感染104例,未合并感染100例。感染组患者血清PCT、hs-CRP水平均明显高于对照组,差异均有统计学意义(P﹤0.01)。血清PCT单独检测诊断ALL患者感染的灵敏度、特异度、阳性预测值、阴性预测值、约登指数分别为82.69%、68.00%、72.88%、79.07%、0.507;血清hs-CRP单独检测诊断ALL患者感染的灵敏度、特异度、阳性预测值、阴性预测值、约登指数分别为87.50%、79.00%、81.25%、85.87%、0.665;PCT+hs-CRP检测诊断ALL患者感染的灵敏度、特异度、阳性预测值、阴性预测值、约登指数分别为96.15%、65.00%、74.07%、94.20%、0.612。PCT+hs-CRP检测诊断ALL患者感染的灵敏度、阴性预测值均高于二者单独检测。结论血清PCT、hs-CRP联合检测对ALL患者的感染情况具有较高的诊断价值。

Objective To investigate the diagnostic value of combined detection of serum procalcitonin(PCT)and high-sensitivity C-reactive protein(hs-CRP)in patients with acute lymphoblastic leukemia(ALL).Method A total of 204 ALL patients were selected and all subjects underwent etiological testing.They were divided into infection group and control group based on the test results,and the serum PCT and hs-CRP levels of the two groups were compared.The diagnostic value of PCT and hs-CRP alone and combined detection for infection in ALL patients was evaluated using the etiological examination results as the gold standard.Result The etiological examination results showed that among the 204 ALL patients,104 were co-infected and 100 were not co-infected.The serum PCT and hs-CRP levels in the infection group were significantly higher than those of the control group,and the differences were statistically significant(P<0.01).The sensitivity,specificity,positive predictive value,negative predictive value,and Youden index of serum PCT alone in diagnosing infection in ALL patients were 82.69%,68.00%,72.88%,79.07%,and 0.507,respectively.The sensitivity,specificity,positive predictive value,negative predictive value,and Youden index of serum hs-CRP alone in diagnosing infection in ALL patients were 87.50%,79.00%,81.25%,85.87%,and 0.665,respectively.The sensitivity,specificity,positive predictive value,negative predictive value,and Youden index of PCT+hs-CRP detection in diagnosing infection in ALL patients were 96.15%,65.00%,74.07%,94.20%,and 0.612,respectively.The sensitivity and negative predictive value of PCT+hs-CRP detection in diagnosing infection in ALL patients were higher than those of the two tests alone.Conclusion The combined detection of serum PCT and hs-CRP has high diagnostic value for infection in ALL patients.