降钙素原、超敏C反应蛋白、红细胞沉降率及S100A9对肺结核合并肺部细菌感染的影响
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摘要
目的比较降钙素原(PCT)、超敏C反应蛋白(hs-CRP)、红细胞沉降率(ESR)及S100A9蛋白对肺结核合并肺部细菌感染中的影响。方法选取2017年9月～2018年8月首都医科大学附属北京胸科医院收治的确诊为肺结核的132例,并根据是否合并肺部细菌感染分为细菌感染组(62例)及单纯肺结核组(70例),对其外周血血浆标本应用免疫荧光法检测PCT,ELISA方法测定S100A9水平,免疫比浊法测定hs-CRP,魏氏法测定ESR。结果细菌感染组患者的PCT、S100A9蛋白及hs-CRP水平与单纯肺结核组比较均显著性增高(P <0.01)。多因素分析PCT及S100A9为肺结核合并肺部细菌感染的独立危险因素。结论肺结核患者PCT及S100A9水平对监测患者是否合并肺部细菌感染具有良好的临床应用价值。
Objective To compare the effects of procalcitonin(PCT), hypersensitive C-reactive protein(hs-CRP), erythrocyte sedimentation rate(ESR) and S100 A9 protein on pulmonary tuberculosis complicated by bacterial infection.Methods Form September 2017 to August 2018 in Beijing Chest Hospital Affiliated to Capital University of Medical Sciences, 132 cases were diagnosed as tuberculosis, and according to whether the pulmonary bacterial infection they were divided into bacterial infection group(62 cases) and simple tuberculosis group(70 cases), the peripheral blood plasma samples application immunofluorescence test PCT, ELISA method for determination of S100 A9 level, immunoturbidimetry was used to determine hs-CRP, the ESR was determined by the Weiss method. Results The levels of PCT,S100 A9 and hs-CRP in the bacterial infection group were significantly higher than those in the pure tuberculosis group(P < 0.01). Multivariate analysis showed that PCT and S100 A9 were independent risk factors for pulmonary tuberculosis complicated by bacterial infection. Conclusion The levels of PCT and S100 A9 in pulmonary tuberculosis patients have good clinical application value in monitoring whether the patients are complicated with pulmonary bacterial infection.
Objective To compare the effects of procalcitonin(PCT), hypersensitive C-reactive protein(hs-CRP), erythrocyte sedimentation rate(ESR) and S100 A9 protein on pulmonary tuberculosis complicated by bacterial infection.Methods Form September 2017 to August 2018 in Beijing Chest Hospital Affiliated to Capital University of Medical Sciences, 132 cases were diagnosed as tuberculosis, and according to whether the pulmonary bacterial infection they were divided into bacterial infection group(62 cases) and simple tuberculosis group(70 cases), the peripheral blood plasma samples application immunofluorescence test PCT, ELISA method for determination of S100 A9 level, immunoturbidimetry was used to determine hs-CRP, the ESR was determined by the Weiss method. Results The levels of PCT,S100 A9 and hs-CRP in the bacterial infection group were significantly higher than those in the pure tuberculosis group(P < 0.01). Multivariate analysis showed that PCT and S100 A9 were independent risk factors for pulmonary tuberculosis complicated by bacterial infection. Conclusion The levels of PCT and S100 A9 in pulmonary tuberculosis patients have good clinical application value in monitoring whether the patients are complicated with pulmonary bacterial infection.
引文
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[13] Vogl T,Ludwig S,Goebeler M,et al. MRP8 and MRP14control microtubule reorganization during transendothelial migration of phagocytes[J]. Blood,2004,104(13):4260-4268.
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[15] Gopal R,Monin L,Torres D,et al. S100A8/A9 Proteins Mediate Neutrophilic Inflammation and Lung Pathology during Tuberculosis[J]. Am J Respir Crit Care Med,2013,188(9):1137-1146.
[16]王东萍,杨静,王庆.肺结核合并肺部感染病原菌分布及耐药性分析[J].临床肺科杂志,2012,17(3):469-470.
[17]何礼贤.降钙素原指导严重细菌感染和脓毒血症诊疗的临床意义[J].中华结核和呼吸杂志,2012,35(8):636-637.
[18]叶枫,钟南山.降钙素原:指导重症细菌感染诊疗的可靠指标[J].中华结核和呼吸杂志,2012,35(11):873.
[19]任晓娟,刘伟,朱一堂,等.PCT、hs-CRP、IL-6对肺结核合并感染的老年患者诊断和预后评估的价值[J].中国医药生物技术,2018,13(1):59-62.
[20]刘丽,乔以凤.PCT联合CRP检测对肺结核患者合并肺部细菌感染的诊断价值分析[J].医药前沿,2018,8(11):173.
[21] Schrag B,Roux-Lombard P,Schneiter D,et a1. Evaluation of C reactive protein,procalcitonin,tumor necrosis factor alpha,interleukin-6,and interleukin 8 as diagnostic parameters in sepsis-related fatalities[J]. Int J Legal Med,2012,126(4):505-512.
[22]王天立,梅牧,徐建仙,等.慢性阻塞性肺疾病患者外周动脉僵硬度的影响因素分析[J].中国现代医生,2017,55(26):20-22,26.
[23]兰芳.稳定期中重度慢阻肺患者血清IL-6、IL-8、TNF-α、hs-CRP与肺功能的相关性研究[J].中国医药科学,2017,7(7):228-229,233.
[2]任晓娟,刘伟,邓瑶瑶,等.血清降钙素原、超敏C反应蛋白、白细胞介素6检测在老年人肺结核治疗中的应用[J].中国社区医师,2018,34(16):109-110,112.
[3] Nicolas P,Camille CG,Lynda M,et al. Prognostic value of PCT in septic emergency patients. Ann Intensive Care,2016,6:47.
[4]李丽娟,陈炜,古旭云,等.血浆PCT和CRP水平的动态变化对脓毒症严重程度的评估及其相关性研究[J].中国实验诊断学,2013,17(6):1010-1013.
[5] Qiuyue L,Liping P,Fen H,et al. Proteomic profiling for plasma biomarkers of tuberculosis progression[J]. Mol Med Rep,2018,18(2):1551-1559.
[6]刘秋月,潘丽萍,骆宝建,等.S100A9蛋白在继发性肺结核进展加重监测中的应用价值[J].中国医药,2017,12(9):1326-1328.
[7]中华人民共和国卫生部.肺结核诊断标准(WS288-2008)[M].北京:人民卫生出版社,2008:1-3.
[8] Recognizing pneumonia[J]. Postgraduate Medicine,1999,105(4):251-252.
[9]吴恩强,陈江平,池宏亮.我国肺结核患者治疗效果的影响因素分析[J].临床合理用药杂志,2016,9(31):111-112.
[10]卫芳征.外周血T细胞亚群和红细胞免疫功能与重症肺结核患者不良预后的相关性[J].临床肺科杂志,2018,23(9):1561-1565.
[11]张哲.227例耐多药肺结核治疗转归情况影响因素研究[J].系统医学,2018,3(2):58-59,62.
[12] Foell D,Wittkowski H,Vogl T,et al. S100 proteins expressed in phagocytes:a novel group of damage-associated molecular pattern molecules[J]. J Leukoc Biol,2007,81(1):28-37.
[13] Vogl T,Ludwig S,Goebeler M,et al. MRP8 and MRP14control microtubule reorganization during transendothelial migration of phagocytes[J]. Blood,2004,104(13):4260-4268.
[14] Za1 H,Rezaei-Tavirani M,Kariminia A,et al. Evaluation of growth inhibitory and apoptosis inducing activity of human calprotectin on the human gastric cell line(AGS)[J].Iran Biomed,2008,12(1):7-14.
[15] Gopal R,Monin L,Torres D,et al. S100A8/A9 Proteins Mediate Neutrophilic Inflammation and Lung Pathology during Tuberculosis[J]. Am J Respir Crit Care Med,2013,188(9):1137-1146.
[16]王东萍,杨静,王庆.肺结核合并肺部感染病原菌分布及耐药性分析[J].临床肺科杂志,2012,17(3):469-470.
[17]何礼贤.降钙素原指导严重细菌感染和脓毒血症诊疗的临床意义[J].中华结核和呼吸杂志,2012,35(8):636-637.
[18]叶枫,钟南山.降钙素原:指导重症细菌感染诊疗的可靠指标[J].中华结核和呼吸杂志,2012,35(11):873.
[19]任晓娟,刘伟,朱一堂,等.PCT、hs-CRP、IL-6对肺结核合并感染的老年患者诊断和预后评估的价值[J].中国医药生物技术,2018,13(1):59-62.
[20]刘丽,乔以凤.PCT联合CRP检测对肺结核患者合并肺部细菌感染的诊断价值分析[J].医药前沿,2018,8(11):173.
[21] Schrag B,Roux-Lombard P,Schneiter D,et a1. Evaluation of C reactive protein,procalcitonin,tumor necrosis factor alpha,interleukin-6,and interleukin 8 as diagnostic parameters in sepsis-related fatalities[J]. Int J Legal Med,2012,126(4):505-512.
[22]王天立,梅牧,徐建仙,等.慢性阻塞性肺疾病患者外周动脉僵硬度的影响因素分析[J].中国现代医生,2017,55(26):20-22,26.
[23]兰芳.稳定期中重度慢阻肺患者血清IL-6、IL-8、TNF-α、hs-CRP与肺功能的相关性研究[J].中国医药科学,2017,7(7):228-229,233.