摘要
目的探讨慢性肾小球肾炎合并细菌感染患者降钙素原(PCT)、可溶性细胞间黏附分子⁃1(sICAM⁃1)、可溶性血管细胞黏附分子⁃1(sVCAM⁃1)的水平及意义。方法选取2017年1月至2018年12月在本院治疗的慢性肾小球肾炎患者105例(慢性肾炎组),其中合并细菌感染患者42例,未合并细菌感染患者63例,同时选取健康自愿者100例作为对照组,比较两组血清PCT、sICAM⁃1、sVCAM⁃1水平差异及是否合并细菌感染的肾小球肾炎患者血清PCT、sICAM⁃1、sVCAM⁃1水平差异,并绘制ROC曲线,比较PCT、sICAM⁃1、sVCAM⁃1单独检测及联合检测对肾小球肾炎合并细菌感染的诊断效能。结果慢性肾小球肾炎组PCT、sICAM⁃1、sVCAM⁃1水平明显高于对照组,差异有统计学意义(P<0.05);慢性肾小球肾炎合并细菌感染患者PCT、sICAM⁃1、sVCAM⁃1水平明显高于未合并细菌感染者,差异有统计学意义(P<0.05);慢性肾小球肾炎合并细菌感染患者中,革兰阴性菌感染患者27例,革兰阳性菌感染患者15例;慢性肾小球肾炎合并革兰阴性菌与革兰阳性菌感染患者PCTs、ICAM⁃1、sVCAM⁃1水平比较,差异无统计学意义(P>0.05)。ROC曲线显示,PCT、sICAM⁃1、sVCAM⁃1单独诊断慢性肾小球合并细菌感染的AUC值为0.886、0.816及0.752,联合检测诊断慢性肾小球肾炎合并细菌感染的AUC值为0.922,PCT、sICAM⁃1、sVCAM⁃1联合检测的诊断效能最高。结论慢性肾小球肾炎患者PCT、sICAM⁃1、sVCAM⁃1水平升高,尤其合并细菌感染者明显升高,但与细菌病原体类型无明显关系,PCT、sICAM⁃1、sVCAM⁃1联合检测对慢性肾小球肾炎合并细菌感染具有较好的诊断价值。
Objective To investigate the levels and significance of procalcitonin(PCT),soluble intercellular adhesion molecule⁃1(sICAM⁃1)and soluble vascular cell adhesion molecule⁃1(sVCAM⁃1)in chronic glomerulonephritis patients complicated with bacterial infection.Methods 105 patients with chronic glomerulonephritis(chronic nephritis group)who were treated in our hospital from January 2017 to December 2018 were selected,including 42 patients with bacterial infection and 63 patients without bacterial infection,and 100 healthy volunteers were selected as control group,levels of PCT,sICAM⁃1 and sVCAM⁃1were detect⁃ed.Difference of serum PCT,sICAM⁃1 and sVCAM⁃1 were compared in these two groups and in glomerulonephritis patients with or without bacterial infection and patients with different bacterial infection,ROC curve were drawn for estiamte diagnostic efficacy of PCT,sICAM⁃1 and sVCAM⁃1 on glomerulonephritis patients with bacterial infection.Results The levels of PCT,sICAM⁃1 and sVCAM⁃1 in chronic nephritis group which were significantly higher than those in control group(P<0.05);The levels of PCT,sICAM⁃1 and sV⁃CAM⁃1 in patients with chronic nephritis complicated with bacterial infection were which were significantly higher than those without bacterial infection(P<0.05);Among the patients with chronic nephritis complicated with bacterial infection,27 were Gram⁃negative bacterial infection and 15 were Gram⁃positive bacterial infec⁃tion;There were no significant difference in PCT sICAM⁃1 and sVCAM⁃1 levels between patients with chron⁃ic nephritis complicated with Gram⁃negative bacteria and Gram⁃positive bacteria(P>0.05).ROC curve showed that the AUC value of PCT,sICAM⁃1,sVCAM⁃1 and PCT+sICAM⁃1+sVCAM⁃1 was 0.886,0.816,0.752 and 0.922 respectively.The AUC value of joint detection was the highest.Conclusion The serum levels of PCT,sICAM⁃1 and sVCAM⁃1 are elevated in patients with chronic nephritis,especially in those with bacteri⁃al infection,but there is no signific
作者
廖荣叶
孙守萍
曹志
LIAO Rongye;SUN Shouping;CAO Zhi(Department of traditional Chinese medicine,the third people’s Hospital of Xinyang,Xinyang,Henan,China,464000;Department of Endocrinology,the third people’s Hospital of Xinyang,Xinyang,Henan,China,464000)
出处
《分子诊断与治疗杂志》
2020年第5期629-633,共5页
Journal of Molecular Diagnostics and Therapy
基金
河南省医学科技攻关计划项目(2018063123)。
