摘要
目的:探讨支气管肺泡灌洗液(Bronchoalveolar lavage fluid,BALF)中肝素结合蛋白(Heparin binding protein,HBP)检测在细菌性肺炎诊断与鉴别诊断中的临床价值。方法:选取2019年1月至2021年1月安徽医科大学第四附属医院呼吸科收治的88例肺炎患者,其中细菌性肺炎48例,非细菌性肺炎40例,另选取同期40例非感染性肺部疾病患者为对照组,检测并比较3组患者BALF中HBP、降钙素原和IL-6水平,采用受试者工作特征(ROC)曲线分析上述各指标对细菌性肺炎的诊断和鉴别诊断效能。结果:细菌性肺炎患者BALF中HBP、IL-6水平均较非细菌性肺炎及对照组明显升高,差异有统计学意义(P<0.05)。ROC曲线结果显示,BALF中HBP和白细胞介素-6(IL-6)诊断细菌性肺炎的AUC分别为0.930、0.893,敏感度分别为88.5%、82.7%,特异度分别为92.5%、92.5%,二者联合检测AUC为0.942,敏感度为94.2%,特异度为95.0%。BALF中HBP、IL-6检测鉴别诊断细菌性与非细菌性肺炎的AUC分别为0.890、0.777,敏感度分别为80.8%、71.2%,特异度分别为91.7%、75.0%,二者联合检测AUC为0.902,敏感度为96.2%,特异度为79.2%。结论:BALF中HBP及IL-6检测对细菌性肺炎的早期诊断和鉴别诊断具有较好的临床价值,二者联合检测临床诊断效能更优。
Objective To explore the clinical value of heparin binding protein(HBP)in bronchoalveolar lavage fluid(BALF)for diagnosis and differential diagnosis of bacterial pneumonia.Methods Eighty eight patients with pulmonary infection from the respiratory department of the Fourth Affiliated Hospital of Anhui Medical University from January 2019 to January 2021 were enrolled in the study,including 48 cases of bacterial pneumonia and 40 cases of non-bacterial pneumonia;meanwhile,40 non-pulmonary infection patients were also enrolled as the control group.The BALF levels of HBP,procalcitonin(PCT),interleukin-6(IL-6)were measured,and the clinical values of the above indexes in differential diagnosis of bacterial and non-bacterial pneumonia were analyzed.Results The BALF levels of HBP and IL-6 in bacterial pneumonia group were significantly higher than those of the non-bacterial pneumonia group and the control group(P<0.05).ROC curve showed that the areas under the curve(AUC)of HBP and IL-6 were 0.930 and 0.893 for the early diagnosis of bacterial pneumonia;and the sensitivity was 88.5%and 82.7%,the specificity was 92.5%and 92.5%,respectively.Combined detection of HBP and IL-6,the AUC was 0.942 and the sensitivity was 94.2%and the specificity was 95.0%.When they were used to distinguish bacterial pneumonia,the AUC of HBP and IL-6 were 0.890 and 0.777,and the sensitivities were 80.8%and 71.2%,and the specificity were 91.7%and 75.0%,respectively.Combined detection of HBP and IL-6,the AUC was 0.902,and the sensitivity was 96.2%and the specificity was 79.2%.Conclusions BALF HBP and IL-6 have good clinical value in the early diagnosis and distinguishing bacterial pulmonary infection and the joint value of the two is better.
作者
毕惠娟
沈继录
方文浩
吴珊
尹丽娜
徐倩
薛莹
柯晨阳
Bi Huijuan;Shen Jilu;Fang Wenhao;Wu Shan;Yin Lina;Xu Qian;Xue Ying;Ke Chenyang(Clinical Laboratory,the Fourth Affiliated Hospital of Anhui Medical University,Hefei 230000,China;Department of Oncology,the Fourth Affiliated Hospital of Anhui Medical University,Hefei 230000,China)
出处
《中华临床感染病杂志》
CAS
CSCD
2021年第2期116-120,共5页
Chinese Journal of Clinical Infectious Diseases
基金
安徽省教育厅高校合作攻关和公共卫生协同创新项目(GXXT-2020-016)
安徽省转化医学研究院科研基金(2017zhyx14)。
