摘要
目的探讨血清降钙素原(PCT)在原发性干燥综合征(pSS)活动和合并感染中的鉴别诊断作用。方法 43例pSS患者,其中发热30例,分为A组:pSS患者稳定期合并感染组(16例)和B组:pSS患者活动期不合并感染组(14例),A组分为A1组:非病毒感染组(9例)和A2组:病毒感染组(7例),另13例不发热pSS病情处于稳定期、不合并感染的患者作为对照组(C组)。利用胶体金法进行血清PCT半定量检测分析,同时测定各项炎症指标:红细胞沉降率(ESR)、C反应蛋白(CRP)、免疫球蛋白(Ig)A、IgG、IgM。结果 A组和B组ESR、IgG升高的比例均大于C组(P<0.01);B组CRP升高的比例大于C组,A组IgA升高的比例大于C组,差异均有统计学意义(均P<0.05);A组PCT的阳性率大于B组和C组(P<0.05),A1组PCT阳性率大于A2组(P<0.05);PCT诊断pSS合并非病毒感染的敏感性为88.9%,特异性为76.5%,阳性预测值为50.0%,阴性预测值为96.3%。结论 PCT能早期鉴别pSS是否感染,尤其是非病毒感染,为鉴别pSS原发病活动还是合并感染提供了特异性的指标,有助于临床医师选择适当的治疗方案。
Objective To evaluate the clinical significance of serum procalcitonin （PCT） in the diagnosis and differentiation of non-viral, viral infections or disease active in the febrile patients with primary Sjoegren＇s syndrome （pSS）. Methods Of 43 pSS patients, 30 patients presented fever 〉 38.5℃ were divided into two groups, group A： inactive pSS with infection （n = 16）, group B： active pSS with infection （n = 14）. Group A were divided into two groups： group AI： 9 patients with non- viral infection, group A2：7 patients with viral infection. Another 13 inactive pSS patients presented no fever with infection as control group （group C）. Serum PCT was measured with semi-quantitative immunochromatog rafic assay. Erythrocyte sedimentation rate （ESR）, C reactive protein （CRP）, immunoglobulin （Ig） A, IgG, IgM were measured at the same time. Re- suits The elevation of ratio ESR, IgG in group A and B were significantly higher than group C （P 〈 0.01）. The elevation of ratio IgA in group A and of ratio CRP in group B were significantly higher than group C （all P 〈 0.05）. The positive rate of PCT in group A was significantly higher than group B and C （P 〈 0.05）. The positive rate of PCT in group A I was signifi- cantly higher than that of group A2 （P 〈 0.05）. For diagnosis of pSS with non virus infection, sensitivity, specificity, posi- tive predictive value and negative predictive value of PCT were 88.9%, 76.5%, 50.0% and 96.3%. Conclusion Serum PCT has good specificity for distinguishing pSS with infection （especially non-viral infection） and active pSS. It is a useful laboratory tool in therapeutic decision of infections and could improve the prognosis in the critical pSS patients.
出处
《中国医药导报》
CAS
2012年第36期82-84,共3页
China Medical Herald
基金
江苏省常州市卫生局指导性科技计划项目(项目编号:wz200624)
关键词
降钙素原
原发性干燥综合征
感染
Procaleitonin
Primary Sjoegren＇s syndrome
Infection
