淋巴细胞亚群、降钙素原及超敏C反应蛋白检测对系统性红斑狼疮合并感染的诊断价值分析

Diagnostic value of lymphocyte subsets,procalcitionin and high-sensitivity C-reactive protein for systemic lupus erythematosus infection

目的探讨检测淋巴细胞亚群、降钙素原(PCT)及超敏C反应蛋白(CRP)对系统性红斑狼疮(SLE)合并感染的诊断价值。方法回顾性分析80例SLE患者淋巴细胞亚群、PCT及CRP水平,将其分为感染组(40例)和非感染组(40例)。对比分析2组之间淋巴细胞亚群、PCT及CRP水平。比较淋巴细胞亚群、PCT、CRP单独及联合检测对SLE合并感染的敏感度及特异性,以受试者工作特征(ROC)曲线分析三者的诊断价值。结果 SLE合并感染组较非感染组淋巴细胞亚群变化:总胸腺依赖性(T)淋巴细胞下降、总骨髓依赖性(B)淋巴细胞上升、T辅助/调节淋巴细胞下降、T抑制/细胞毒性淋巴细胞上升、总自然杀伤细胞(NK)淋巴细胞下降、T淋巴细胞辅助(H)/抑制(S)比值下降(P<0.05)。淋巴细胞总数2组之间比较差异无统计学意义(P>0.05)。SLE合并感染组较非感染组PCT、CRP升高(P<0.05)。ROC曲线分析得出淋巴细胞亚群中T抑制/细胞毒性淋巴细胞(CD3+/CD8+)在对角段上,曲线下面积(AUC)为0.657(P<0.05)。PCT、CRP的AUC分别为0.710、0.589(P<0.05),淋巴细胞亚群、PCT、CRP联合检测的敏感度及特异性明显高于单独检测。结论淋巴细胞亚群在SLE合并感染患者中显著异常,PCT、CRP在SLE合并感染患者中水平升高,这对鉴别SLE病情活动与感染有一定价值。淋巴细胞亚群、PCT、CRP联合检测对SLE合并感染有很好的预测价值。

Objective To investigate the diagnostic value of detecting lymphocyte subsets,procalcitonin and high-sensitivity C-reactive protein for systemic lupus erythematosus infection.Methods The lymphocyte subsets,PCT and CRP levels of 80 patients with SLE were retrospectively analyzed and were divided into infection group and non-infected group,with 40 cases each.The sensitivity and specificity of lymphocyte subsets,PCT,and CRP alone and in combination in SLE infection were compared,and the diagnostic value of the three was analyzed by receiver operating characteristic curve.Results Changes in lymphocyte subsets in the SLE-infected group compared with non-infected groups:total thymus-dependent lymphocyte count decreased,total bone marrow-dependent lymphocyte count increased,T-assisted/regulated lymphocyte decreased,T inhibition/cytotoxic lymphocyte increased,total natural killer lymphocyte decreased,and T lymphocyte-assisted/inhibition ratio decreased(P<0.05).The total number of lymphocytes was not significantly different between the two groups.The PCT and CRP were higher in the SLE co-infected group than in the non-infected group(P<0.05);ROC curve analysis showed that T suppression/cytotoxic lymphocytes(CD3+/CD8+)in the lymphocyte subsets were on the diagonal segment,and the area under the curve(AUC)was 0.657(P<0.05).The AUC of PCT and CRP were respectively 0.710 and 0.589(P<0.05).The sensitivity and specificity of combined detection of lymphocyte subsets,PCT and CRP were significantly higher than those of single detection.Conclusion Lymphocyte subsets are significantly abnormal in patients with SLE co-infection,and PCT and CRP are elevated in patients with SLE co-infection,which is valuable for identifying SLE disease activity and infection.The combined detection of lymphocyte subsets,PCT and CRP has a good predictive value for SLE co-infection.