血清C-反应蛋白联合降钙素原检测诊断肝癌患者介入术后感染的价值
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摘要
目的:研究血清降钙素原与C-反应蛋白联合监测肝癌患者介入手术感染价值,为临床诊治提供参考。方法:选取我院于2011年10月至2017年10月期间收治的肝癌介入手术感染患者134例为试验组,另选同期未感染患者120例作为对照组。两组患者均采用免疫比浊法测定C-反应蛋白含量,采用电化学发光法测定降钙素原含量,对比其血清C-反应蛋白和降钙素原含量、C-反应蛋白及降钙素原阳性率、C-反应蛋白联合降钙素原诊断灵敏度和特异度。结果:试验组血清降钙素原及C-反应蛋白含量均高于对照组,差异有统计学意义(P <0. 05);试验组降钙素原及C-反应蛋白阳性率均高于对照组,差异有统计学意义(P <0. 05);降钙素原联合C-反应蛋白的诊断灵敏度及特异度优于单项诊断,差异有统计学意义(P <0. 05)。结论:肝癌患者介入手术感染后血清降钙素原及C-反应蛋白含量升高明显,若联合降钙素原及C-反应蛋白诊断,其灵敏度及特异度更高,可为临床诊治提供重要参考。
Objective: To study the value of serum procalcitonin and C-reactive protein in monitoring the infection rate of interventional operation in patients with hepatocellular carcinoma,and to provide reference for clinical diagnosis and treatment. Methods: From October 2011 to October 2017,134 cases of liver cancer patients with interventional operation were selected as experimental group,and 120 cases of non infected patients were selected as control group. Two groups of patients were determined by C-reaction protein immunoturbidimetric assay,determination of procalcitonin in the electrochemical luminescence method,compared the serum C-reactive protein and procalcitonin C-content,C-reactive protein and procalcitonin positive rate,C-reactive protein combined with procalcitonin diagnostic sensitivity and specificity. Results: Procalcitonin and C-reactive protein content in experimental group were higher than the control group,and the difference was statistically significant( P < 0. 05). Experimental group of procalcitonin and C-reactive protein positive rates were higher than the control group,and the difference was statistically significant( P < 0. 05). Procalcitonin and C-reactive protein sensitivity and the specificity is superior to single diagnosis,and the difference was statistically significant( P < 0. 05). Conclusion: In patients with hepatocellular carcinoma after interventional operation infection,serum procalcitonin and C-reactive protein levels increased significantly.The sensitivity and specificity of combining procalcitonin with C-reactive are higher,can provide important reference for clinical diagnosis and treatment.
Objective: To study the value of serum procalcitonin and C-reactive protein in monitoring the infection rate of interventional operation in patients with hepatocellular carcinoma,and to provide reference for clinical diagnosis and treatment. Methods: From October 2011 to October 2017,134 cases of liver cancer patients with interventional operation were selected as experimental group,and 120 cases of non infected patients were selected as control group. Two groups of patients were determined by C-reaction protein immunoturbidimetric assay,determination of procalcitonin in the electrochemical luminescence method,compared the serum C-reactive protein and procalcitonin C-content,C-reactive protein and procalcitonin positive rate,C-reactive protein combined with procalcitonin diagnostic sensitivity and specificity. Results: Procalcitonin and C-reactive protein content in experimental group were higher than the control group,and the difference was statistically significant( P < 0. 05). Experimental group of procalcitonin and C-reactive protein positive rates were higher than the control group,and the difference was statistically significant( P < 0. 05). Procalcitonin and C-reactive protein sensitivity and the specificity is superior to single diagnosis,and the difference was statistically significant( P < 0. 05). Conclusion: In patients with hepatocellular carcinoma after interventional operation infection,serum procalcitonin and C-reactive protein levels increased significantly.The sensitivity and specificity of combining procalcitonin with C-reactive are higher,can provide important reference for clinical diagnosis and treatment.
引文
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[12]Liu Pingping,Zheng Li,Zhang Hao,et al. The value of PCT and C-reactive protein in the early diagnosis of malignant tumor combined infection[J]. Zhejiang Clinical Medicine,2014,15(9):1383-1384.[刘平平,郑力,张浩,等. PCT和C-反应蛋白在恶性肿瘤合并感染的早期诊断价值[J].浙江临床医学,2014,15(9):1383-1384.]
[13]He Guoqiang,Zhang Heping,Dang Yuanna. The application of serum calcitonin detection in the diagnosis of infection of malignant tumor patients[J]. Chinese Journal of Nosocomial Infection,2015,27(14):3135-3137.[何国强,张和平,党元娜.血清降钙素原检测在恶性肿瘤患者感染诊断中的应用评价[J].中华医院感染学杂志,2015,27(14):3135-3137.]
[14]Xu Liwen,Zhang Qin,Hu Ming,et al. Infection investigation and related factors analysis of malignant tumor patients[J]. Chinese Journal of Nosocomial Infection,2016,26(11):2526-2528.[许琍文,张芹,胡明,等.恶性肿瘤患者感染调查及相关因素分析[J].中华医院感染学杂志,2016,26(11):2526-2528.]
[15]Qiao Yongqi,Li Qing,Yang Yongming,et al. The value of serum procalcitonin and C-reactive protein in the detection of early infection in patients with emergency malignant tumor[J]. Modern Oncology,2018,26(5):759-762.[乔永启,李青,杨永明,等.血清降钙素原与C-反应蛋白联合检测急诊恶性肿瘤患者早期感染的价值[J].现代肿瘤医学,2018,26(5):759-762.]
[16]Jiang Zhengcai,Zhu Shaojun,Dong Jianda,et al. Analysis of influencing factors of nosocomial infection in patients with malignant tumor[J]. Journal of Infection Science in Chinese Hospital,2016,26(8):1781-1783.[蒋正财,朱少俊,董剑达,等.恶性肿瘤患者医院感染影响因素分析研究[J].中华医院感染学杂志,2016,26(8):1781-1783.]
[2]Wei Yuanyuan,Hu Yijiang,Gu Yongkun. Evaluation of serum calcitonin and C-reactive protein levels in the detection of infectious diseases in malignant tumor patients[J]. Chinese Journal of Nosocomial Infection,2015,14(1):16-18.[魏媛媛,胡邑姜,谷永坤.血清降钙素原与C-反应蛋白水平在检测恶性肿瘤患者感染性疾病中的应用评价[J].中华医院感染学杂志,2015,14(1):16-18.]
[3]Da Chunli,Yang Feng,Li Yu. The clinical significance of calcitonin and APACHE II score in the diagnosis and treatment of catheterrelated hematogenous infection in malignant tumor patients[J].Xinjiang Medicine,2012,42(3):13-16.[达春丽,杨峰,李瑜.降钙素原和APACHE II评分在恶性肿瘤患者导管相关性血行感染诊疗中的临床意义[J].新疆医学,2012,42(3):13-16.]
[4]Liu Rong. Evaluation of serum calcitonin and C-reactive protein levels in the detection of infectious diseases in malignant tumor patients[J]. Journal of Aeronautics and Astronautics,2016,27(1):40-41.[刘荣.血清降钙素原与C-反应蛋白水平在检测恶性肿瘤患者感染性疾病中的应用评价[J].航空航天医学杂志,2016,27(1):40-41.]
[5]Hao Jingduo,Cen Xueying,Ge Zuyin. Evaluation of serum calcitonin and C-reactive protein levels in the monitoring of infection in patients with malignant tumors[J]. Chinese Journal of Nosocomial Infection,2015,17(2):268-270.[郝敬铎,岑雪英,葛祖荫.血清降钙素原及C-反应蛋白水平在恶性肿瘤患者感染监测中的评价[J].中华医院感染学杂志,2015,17(2):268-270.]
[6]Zhang Jingya,Cui Ranliang,Wei Qian,et al. The value of calcitonin in the diagnosis of postoperative infection in patients with ICU malignant tumor[J]. Chinese General Surgery Journal,2016,31(8):689-690.[张静雅,崔冉亮,魏倩,等.降钙素原在ICU恶性肿瘤患者术后感染中的诊断价值[J].中华普通外科杂志,2016,31(8):689-690.]
[7]Li Yanwei,Li Ronghui,Ju Chuanyu,et al. The application value of combined detection of PCT,CRP and WBC in patients with malignant tumor after radiotherapy and chemotherapy[J]. Clinical Medicine Literature Journal,2017,4(10):198-202.[李彦伟,李荣辉,鞠传余,等.恶性肿瘤放化疗后感染患者PCT、CRP及WBC联合检测的应用价值[J].临床医药文献电子杂志,2017,4(10):198-202.]
[8]Wang Shufeng,Du Ping,Yao Xiaobin. Changes and significance of calcitonin and C reactive protein in patients with malignant tumors and bacterial infections[J]. Journal of Chinese Practical Diagnosis and Treatment,2015,29(5):517-518.[王书锋,杜平,姚晓斌.恶性肿瘤并细菌感染患者降钙素原与C反应蛋白水平变化及意义[J].中华实用诊断与治疗杂志,2015,29(5):517-518.]
[9]Vos LM,Morand PC,Biau D,et al. High frequency of polymicrobial infections after surgical resection of malignant bone and soft tissue tumors:A retrospective cohort study[J]. Infectious Diseases and Therapy,2015,4(3):1-13.
[10]Zhang Hua,Zhou Wenbin,Allimus. The differential significance of calcitonin and C-reactive protein in patients with malignant tumor fever[J]. Journal of Minzu University of China(Natural Science Edition),2016,25(2):68-70.[张华,周文斌,阿里穆斯.降钙素原与C-反应蛋白在恶性肿瘤发热患者中的鉴别意义[J].中央民族大学学报(自然科学版),2016,25(2):68-70.]
[11]Chu NJ,Armstrong TD,Jaffee EM. Nonviral oncogenic antigens and the inflammatory signals driving early cancer development as targets for cancer immunoprevention[J]. Clinical Cancer Research,2015,21(7):1549-1557.
[12]Liu Pingping,Zheng Li,Zhang Hao,et al. The value of PCT and C-reactive protein in the early diagnosis of malignant tumor combined infection[J]. Zhejiang Clinical Medicine,2014,15(9):1383-1384.[刘平平,郑力,张浩,等. PCT和C-反应蛋白在恶性肿瘤合并感染的早期诊断价值[J].浙江临床医学,2014,15(9):1383-1384.]
[13]He Guoqiang,Zhang Heping,Dang Yuanna. The application of serum calcitonin detection in the diagnosis of infection of malignant tumor patients[J]. Chinese Journal of Nosocomial Infection,2015,27(14):3135-3137.[何国强,张和平,党元娜.血清降钙素原检测在恶性肿瘤患者感染诊断中的应用评价[J].中华医院感染学杂志,2015,27(14):3135-3137.]
[14]Xu Liwen,Zhang Qin,Hu Ming,et al. Infection investigation and related factors analysis of malignant tumor patients[J]. Chinese Journal of Nosocomial Infection,2016,26(11):2526-2528.[许琍文,张芹,胡明,等.恶性肿瘤患者感染调查及相关因素分析[J].中华医院感染学杂志,2016,26(11):2526-2528.]
[15]Qiao Yongqi,Li Qing,Yang Yongming,et al. The value of serum procalcitonin and C-reactive protein in the detection of early infection in patients with emergency malignant tumor[J]. Modern Oncology,2018,26(5):759-762.[乔永启,李青,杨永明,等.血清降钙素原与C-反应蛋白联合检测急诊恶性肿瘤患者早期感染的价值[J].现代肿瘤医学,2018,26(5):759-762.]
[16]Jiang Zhengcai,Zhu Shaojun,Dong Jianda,et al. Analysis of influencing factors of nosocomial infection in patients with malignant tumor[J]. Journal of Infection Science in Chinese Hospital,2016,26(8):1781-1783.[蒋正财,朱少俊,董剑达,等.恶性肿瘤患者医院感染影响因素分析研究[J].中华医院感染学杂志,2016,26(8):1781-1783.]