摘要
目的通过分析发热伴血小板减少综合征(SFTS)患者血管紧张素Ⅱ(AngⅡ)、C反应蛋白(CRP)水平及其与临床指标的相关性,探讨AngⅡ、CRP对SFTS早期诊断和预后评估的临床价值。方法收集SFTS患者共72例,分为普通组和危重组,采集所有病例极期和恢复期血样,测定AngⅡ、CRP、血清病毒载量、血常规、生化指标等,分析AngⅡ、CRP水平与血清病毒载量、白细胞(WBC)、血小板(PLT)、血清酶学的关系。利用ROC曲线评价AngⅡ、CRP对SFTS病情严重度和转归的预测价值。另选取31例健康查体者作为对照。结果 SFTS患者极期AngⅡ、CRP水平均明显升高,与WBC、PLT呈负相关,与血清病毒载量、丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、乳酸脱氢酯(LDH)、肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)等组织损伤指标水平呈正相关,病情越重,AngⅡ、CRP水平越高。恢复期的AngⅡ、CRP水平明显下降,至正常或接近正常水平,WBC、PLT和血清酶学等指标均明显恢复,血清病毒载量明显下降。AngⅡ、CRP的ROC曲线下面积(AUC)分别为0.880、0.703。结论 AngⅡ和CRP可作为SFTS早期诊断、病情判断和预后评估的重要参照指标,AngⅡ的预测价值优于CRP。
Objective To analyze the levels of angiotensin Ⅱ（Ang Ⅱ ） and C reactive protein （CRP） in pa- tients with fever of thrombocytopenia syndrome （SFTS） and their correlations with clinical parameters, and to study the clinical values of AngⅡand CRP in early diagnosis and prognosis of SFTS. Methods A total of 72 cases of SFFS were collected and divided into normal group and critical group. The blood samples of all cases in the acute phase and recovery phase were collected for assessment of Ang Ⅱ , CRP, serum viral load, blood routine, and biochemical indexes. The cor- relations of Ang Ⅱ and CRP with serum viral load, leukocyte （WBC） , platelet （PLT） and serum enzymology were ana- lyzed. Thew ROC curve was applied to evaluate the predictive value of Ang Ⅱ and CRP on severity and outcome of SFTS. Another 31 healthy subjects were selected as control. Results Ang Ⅱ and CRP levels were significantly increased in a- cute phase, negatively correlated with WBC and PLT counts, and positively correlated with serum viral load, ALT, AST, LDH, CK, and CK - MB. The severer the illness was, the higher the Ang Ⅱ and CRP were. The levels of Ang Ⅱ and CRP in recovery period were significantly reduced. The areas under ROC curve （AUCs） of AngⅡ and CRP were 0. 880 and 0. 703, respectively. Conclusion Ang Ⅱand CRP can be used as important reference indexes for early diagnosis, prognosis and prognostic evaluation of SFTS. Compared with CPR, the prediction value of Ang Ⅱ is better.
出处
《广东医学》
CAS
北大核心
2017年第11期1699-1702,共4页
Guangdong Medical Journal
基金
山东省潍坊市卫生局科研项目计划(编号:2013105)
