引用本文:郑泓斌,林瑞云.降钙素原在恶性肿瘤并发中性粒细胞缺乏伴发热患者感染风险评估中的临床意义[J].中国临床新医学,2018,11(11):1103-1106.
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降钙素原在恶性肿瘤并发中性粒细胞缺乏伴发热患者感染风险评估中的临床意义
郑泓斌,林瑞云
515031 广东,汕头大学医学院附属肿瘤医院重症医学科
摘要:
[摘要] 目的 探讨降钙素原(PCT)在恶性肿瘤放化疗致中性粒细胞缺乏伴发热患者中对潜在严重感染可能及危险分层诊断的指导意义。方法 前瞻性入组2016-07~2017-10在汕头大学医学院附属肿瘤医院抗肿瘤治疗期间出现中性粒细胞缺乏伴发热患者90例。参照美国感染病学会(IDSA)中性粒细胞缺乏伴发热患者抗菌药物临床应用指南(2010年版),将中性粒细胞缺乏伴发热患者分为高危组和低危组各45例,分别检测两组患者的血清PCT水平,对比分析两组患者的PCT值是否存在差异。结果 高危组与低危组比较,PCT显著增高[7.06(0.40~100.00)ng/ml vs 1.16(0.08~5.25)ng/ml,P=0.020];PCT>1.32 ng/ml为临界值诊断中性粒细胞减少伴发热患者高危组的敏感度为71.8%,特异度为77.5%,曲线下面积为0.778(95%CI:0.676~0.880,P<0.001)。结论 血清PCT检测是中性粒细胞缺乏伴发热患者的感染危险度评估的有效辅助指标。
关键词:  降钙素原  中性粒细胞缺乏  发热  感染
DOI:10.3969/j.issn.1674-3806.2018.11.09
分类号:R 730
基金项目:广东省医学科学技术研究基金项目(编号:2016114185350673)
The clinical value of procalcitonin in risk assessments of infection in patients with cancer complicated with febrile neutropenia
ZHENG Hong-bin, LIN Rui-yun
Department of Critical Care Medicine, Tumor Hospital Affiliated to Medical College of Shantou University, Guangdong 515031, China
Abstract:
[Abstract] Objective To investigate the guiding significance of procalcitonin(PCT) in diagnosis of potential serious infection and risk stratification in patients with neutropenia and fever. Methods Based on prospective cohort study design, 90 febrile neutropenia patients who were treated in Tumor Hospital Affiliated to Medical College of Shantou University from July 2016 to October 2017 were divided into high-risk group and low-risk group, with 45 cases in each group according to the Chinese Guidelines for the Clinical Application of Antibacterial Drugs for Agranulocytosis with Fever(the 2010 version). The levels of serum PCT were detected and compared between the two groups. Results The level of serum PCT in the high-risk group was significantly higher than that in the low-risk group[7.06(0.40~100.00)ng/ml vs 1.16(0.08~5.25)ng/ml, P=0.020)]. A PCT cut-off value>1.32 ng/ml provided a sensitivity of 71.8% and a specificity of 77.5% for diagnosis of febrile neutropenia in the patients in the high-risk group[AUC=0.778(95%CI: 0.676~0.880, P<0.001)]. Conclusion  Detection of serum PCT can be an effective auxiliary index for risk assessment of infection in patients with cancer complicated with febrile neutropenia.
Key words:  Procalcitonin(PCT)  Neutropenia  Fever  Infection