摘要
目的探讨降钙素原(procalcitonin,PCT)、C反应蛋白(C-reactive protein,CRP)鉴别非小细胞肺癌患者肿瘤热与感染性发热的临床价值。方法回顾性分析住院的非小细胞肺癌患者(中性粒细胞正常)96例,将患者分为3组:血源性感染组21例,局部感染组49例,肿瘤热组26例。对各组PCT和CRP测定值进行统计分析。结果血源性感染组、局部感染组PCT、PCT/CRP较肿瘤热组明显升高,血源性感染组CRP较肿瘤热组明显升高,局部感染组与肿瘤热组CRP差异无统计学意义。通过曲线下面积得出PCT/CRP为最佳判断指标。在鉴别肿瘤热与局部感染时,PCT/CRP的截断值为0.005 5,其敏感度为81.6%,特异度为96.2%;在鉴别肿瘤热与血源性感染时,PCT/CRP的截断值为0.005 0,其敏感度为90.5%,特异度为92.3%。结论在诊断感染方面,PCT/CRP、PCT优于CRP,其中PCT/CRP是鉴别肿瘤热与感染性发热较好的指标。
Objective To explore the clinical value of procalcitonin（PCT）and C-reactive protein（CRP）for discrimination between tumor fever and infectious fever in non-small cell lung cancer patients.Methods In our study,we retrospectively analyzed the levels of PCT and CRP in patients with non-small cell lung cancer and fever to the hospital,and the febrile patients with non-neutropenia were entrolled.The 96 patients were classified into three groups：21 patients with bloodstream infection（BSI）,49 patients with localized bacterial infection（LBI）,26 patients with tumor fever（TF）.The diagnostic values of PCT and CRP were analyzed for each group.Results The study found that the PCT level and PCT/CRP ratio were significantly higher in BSI group and LBI group than in TF group.The patients with bloodstream infection had significantly higher CRP level than those with tumor fever,however,there was no statistical difference in patients with localized bacterial infection and tumor fever.PCT/CRP was the best test for discriminating tumor fever and infectious fever in terms of the area under the curve of the ROC curve.To discriminate between tumor fever and localized bacterial infection,at the cut-off of0.005 5 for PCT/CRP,the sensitivity and specificity of PCT/CRP were 81.6% and 96.2%.To discriminate between tumor fever and bloodstream infection,at the cut-off of 0.005 0 for PCT/CRP,the sensitivity and specificity of PCT/CRP were 90.5%and 92.3%.Conclusion The PCT level and PCT/CRP ratio were more useful parameters than CRP level for discriminating patients with tumor fever and infectious fever.Furthermore,PCT/CRP ratio was the best marker for discrimination between tumor fever and infectious fever.
作者
赵志芳
李旭泽
赵云霞
李亚华
王东昌
陈刚
ZHAO Zhi-fang;LI Xu-ze;ZHAO Yun-xia;LI Ya-hua;WANG Dong-chang;CHEN Gang(Department of Respiration, the Third Hospital of Hebei Medical University, Shijiazhuang050051, China;Department of Anesthesiology, the Second Hospital of HebeiMedical University, Shijiazhuang 050000, China)
出处
《河北医科大学学报》
CAS
2018年第5期500-503,共4页
Journal of Hebei Medical University
关键词
肺肿瘤
发热
降钙素原
C反应蛋白质
lung neoplasms
fever
procalcitonin
C-reactive protein
