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降钙素原在急性白血病化疗后中性粒细胞缺乏合并细菌感染中的临床意义 被引量:14

Clinical significance of procalcitonin in acute leukemia with agranulocytosis and bacterial infection after chemotherapy
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摘要 目的探讨降钙素原(PCT)在急性白血病化疗后中性粒细胞缺乏合并细菌感染中的临床意义。方法选取2011年12月~2012年12月入院47例细菌感染患者。根据血培养结果,分成血培养阴性组和血培养阳性组。血培养阳性组中微生物学确诊为G-菌感染组和G+菌感染组。除行常规血培养检查外,均在发热12h内行血清PCT测定。PCT测定采用快速半定量固相免疫测定法。综合分析患者PCT的含量及动态变化。结果血培养阳性组PCT水平明显高于血培养阴性组,两组比较差异有统计学意义(P<0.05)。G-菌感染组较G+菌感染组PCT值增高(P<0.05)。当感染得到控制后PCT浓度随之下降。结论在急性白血病化疗后中性粒细胞缺乏合并感染的患者中,血清PCT值可作为预测细菌感染的早期诊断指标;动态监测血清PCT,能反映病情变化及细菌感染的严重程度;血清PCT检测的结果可反映抗菌药物的疗效,为抗生素及时调整提供依据。 Objective To explore the clinical signiticance of procalcitonin (PCT) in acute leukemia with agranulocyto- sis and bacterial infection after chemotherapy. Methods A total of 47 hospitalized patients with bacterial infections from Dec. 2011 to Dec. 2012 were selected in hospital. All patients were divided into blood culture negative group and blood culture positive group according to the blood culture result. The patients of blood culture positive group were di- vided into the G- bacteria group and the G~ bacteria group on the basis of microbiology diagnosed. All the patients in this research received routine blood culture, and the serum PCT were determined after fever within 12 hours by half quantitative solid phase immunoassays. Comprehensively analyzed the content and dynamic change of PCT in patients. Results The serum PCT levels of the blood culture positive group were significantly higher than those of the blood culture negative group, the differences were statistically significant (P 〈 0.05). The serum PCT levels of the G- bacteria infection group were higher than those of the G~ bacteria infection group (P 〈 0.05). When the infection was under control, the PCT level decreased correspondingly. Conclusion Serum PCT can serve as the early marker for the diag- nosis of bacterial infections in acute leukemia with agranulocytosis and infection after chemotherapy. Dynamic monitor- ing serum PCT, can reflect the change in state of illness and the severity of the bacterial infection; The results of serum PCT test can reflect the efficacy of antibiotics, and provide guidelines for clinicians to adjust the antibiotics in time.
出处 《中国当代医药》 2013年第12期111-112,115,共3页 China Modern Medicine
关键词 降钙素原 急性白血病 中性粒细胞缺乏 细菌感染 Proealeitonin Acute leukemia Agranulocytosis Bacterial infection
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