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2018 年第 11 期 第 13 卷

糖化血红蛋白联合降钙素原和C反应蛋白及可溶性髓样细胞触发性受体1对糖尿病合并肺部感染严重程度的评估价值

Value of glycosylated hemoglobin combined with procalcitonin, C-reactive protein and soluble myeloid cell trigger receptor-1 in evaluation of pulmonary infection in patients with diabetes mellitus

作者:黄轶华韩钧凌俞力军颜保松

英文作者:

单位:571159海口,解放军第一八七中心医院消化内分泌科(黄轶华、韩钧凌、俞力军),检验科(颜保松)

英文单位:

关键词:糖尿病;肺部感染;糖化血红蛋白;降钙素原;可溶性髓样细胞触发性受体1

英文关键词:

  • 摘要:
  • 【摘要】目的    探讨糖尿病患者合并肺部感染时,糖化血红蛋白(HbA1c)、降钙素原、C反应蛋白(CRP)、可溶性髓样细胞触发性受体1(sTREM-1)联合检测对判断病情严重程度的临床价值。方法    选取2016年1月至2017年12月解放军第一八七中心医院收治的糖尿病合并肺部感染患者64例,按临床肺部感染评分分为轻度组(34例)、中度组(21例)、重度组(9例);另选取13例无感染的糖尿病患者作为对照组。比较各组间HbA1c及多个炎症指标的水平差异,通过受试者工作特征(ROC)曲线分析HbA1c、降钙素原、CRP、sTREM-1单独检测和联合检测时对病情判断的价值。结果    HbA1c、降钙素原、CRP、sTREM-1在4组间比较,差异均有统计学意义(均P<0.05)。将HbA1c、降钙素原、CRP、sTREM-1联合检测用于判断肺部感染严重程度的ROC曲线下面积(AUC)分别为0.937(区分重度与中度)、0.957(区分中度与轻度),大于各指标单独检测时的AUC:HbA1c(0.902、0.908)、降钙素原(0.905、0.924)、CRP(0.852、0.840)、sTREM-1(0.902、0.901);联合检测的敏感度和特异度均优于单独检测。结论    糖尿病患者合并肺部感染时,HbA1c、降钙素原、CRP、sTREM-1联合检测较单独检测能更有效地判断病情的严重程度。

  • 【Abstract】Objective    To investigate the value of combined detection of glycosylated hemoglobin(HbA1c), procalcitonin(PCT), C-reactive protein(CRP) and soluble myeloid cell trigger receptor-1(sTREM-1) in evaluation of the severity of pulmonary infection in patients with diabetes mellitus. Methods    From January 2016 to December 2017, 64 diabetic patients with pulmonary infection in the 187th Central Hospital of the Chinese People′s Liberation Army were divided into mild(n=34), moderate(n=21) and severe(n=9) groups according to the Clinical Pulmonary Infection Score; 13 diabetic patients without infection were included in control group. HbA1c and inflammatory markers were tested. Values of HbA1c, PCT, CRP, sTREM-1 individual and combined detection in evaluating the severity of pulmonary infection were analyzed by the receiver operating characteristic(ROC) curve. Results    Levels of HbA1c, PCT, CRP and sTREM-1 showed significant differences among the 4 groups(P<0.05). Areas under ROC curve(AUC) of HbA1c, PCT, CRP and sTREM-1 joint detection to determine the severity of pulmonary infection were 0.937(between severe and moderate infection) and 0.957(between moderate and mild infection), which were higher than those of the single indicator detection results: HbA1c(0.902, 0.908), PCT(0.905, 0.924), CRP(0.852, 0.840), sTREM-1(0.902, 0.901). Sensitivity and specificity of joint detection were higher than those of single factor detection. Conclusion    In diabetic patients with pulmonary infection, combined detection of HbA1c, PCT, CRP and sTREM-1 is more effective than single factor detection in evaluating the severity of infection.

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