新型及传统炎症指标对血液疾病患者细菌感染的评估

Evaluated of Novel and Traditional Inflammatory Markers on BacterialInfectionin Patients with Hematological Diseases

目的探究新型及传统炎症指标中性粒细胞载脂蛋白(human neutrophil apolipoprotein,HNL)、中性粒细胞CD64(neutrophtl CD64,nCD64)、降钙素原(procalcitonin,PCT)、白细胞(white blood cell,WBC)计数对血液疾病细菌感染的诊断价值。方法回顾性分析85例细菌感染血液疾病患者临床资料,设为感染组,另外选取同期非细菌感染血液疾病患者62例为非感染组。比较2组患者一般资料、外周血HNL、nCD64、PCT、WBC计数水平差异,采用受试者操作特征(receiver operating characteristic,ROC)曲线描述上述指标应用于血液疾病细菌感染患者的诊断效能。结果感染组外周血PCT、HNL、nCD64、WBC计数水平均高于非感染组,差异有统计学意义(P<0.001),PCT、HNL、nCD64、WBC计数水平及联合预测诊断血液疾病细菌性感染的敏感度分别为81.18%、82.35%、78.82%、77.65%及96.47%,特异度分别为85.88%、89.41%、88.68%、88.24%及78.82%。ROC曲线结果显示,PCT、HNL、nCD64、WBC计数水平及联合预测诊断血液疾病细菌性感染的曲线下面积分别为0.871、0.907、0.891、0.788及0.984。结论外周血PCT、HNL、nCD64、WBC计数水平对诊断血液疾病细菌感染均有评估价值,其中以联合诊断价值最大。

Objective To explore the diagnostic value of novel and traditional inflammatory markers,including human neutrophil apolipoprotein(HNL),neutrophil CD64(nCD64)procalcitonin(PCT)and white blood cell(WBC)count,for bacterial infection of hematological diseases.Methods The clinical data of 85 patients with bacterial infected blood diseases were retrospectively analyzed and set as the infected group,and another 62 patients with non-bacterial infected blood diseases in the same period were selected as the non-infected group.The general data,peripheral blood HNL,nCD64,PCT,WBC count were compared between the two groups.Receiver operating characteristic(ROC)curve was used to describe the diagnostic efficiency of the above indicators on patients with bacterial infections in haematological disorders.Results The levels of peripheral blood PCT,HNL,nCD64,WBC count and combined prediction in infection group were higher than those in non-infected group(P<0.001).The sensitivities of PCT,HNL,nCD64,WBC count and combined prediction in the diagnosis of hematological diseases with bacterial infection were 81.18%,82.35%,78.82%,77.65%and 96.47%,and the specificities were 85.88%,89.41%,88.68%,88.24%and 78.82%respectively.The results of the ROC curve showed that the area under the curve for PCT,HNL,nCD64,WBC count levels and combined predictive diagnosis of bacterial infections in blood disorders were 0.871,0.907,0.891,0.788 and 0.984,respectively.Conclusion The levels of PCT,HNL,nCD64 and WBC count in peripheral blood have evaluated value in the diagnosis of hematological diseases with bacterial infection,and combined prediction has the greatest diagnostic value.