Clinical significance of procalcitonin and leukocyte count in diagnosis of complicated pulmonary infection in patients with maintenance hemodialysis
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摘要: 目的 探讨降钙素原（procalcitonin，PCT）、白细胞计数（WBC）在维持性血液透析（maintenance hemodialysis，MHD）患者合并肺部感染中的临床应用价值。方法 收集2017年6月至2018年12月在川北医学院附属医院血液净化中心行MHD治疗且肺部感染诊断明确的87例患者作为感染组，同时期无肺部感染或其他部位感染的MHD患者共75例作为非感染组，收集患者的一般资料及临床检验资料，包括年龄、性别、体质量指数、原发病、血常规、血生化、甲状旁腺激素、C反应蛋白、PCT等进行回顾性分析。结果 （1）与非感染组相比，感染组的白蛋白、总胆固醇水平明显降低；WBC、中性粒细胞百分比、PCT、C反应蛋白水平明显升高，差异有统计学意义（P<0.05）。（2）多因素Logistic回归分析结果提示：PCT（OR=70.625，95%CI 13.783~361.891，P<0.05）、WBC（OR=1.435，95%CI 1.133~1.817，P<0.05）是MHD患者合并肺部感染的独立危险因素。（3）PCT、WBC、PCT+WBC两者联合诊断MHD患者合并肺部感染的受试者工作特征曲线下面积分别为0.880（0.828~0.932）、0.717（0.638~0.797）和0.905（0.859~0.951）（均P<0.05）。结论 PCT、WBC是MHD患者合并肺部感染的独立危险因素，PCT与WBC两者联合检测对肺部感染的诊断效能更优。Abstract: Objective To investigate the clinical value of procalcitonin (PCT) and white blood cell count (WBC) in diagnosis of complicated pulmonary infection in patients with maintenance hemodialysis.Methods A total of 87 patients were selected as the infection group,who underwent maintenance hemodialysis (MHD) in Blood Purification Centre,Affiliated Hospital of North Sichuan Medical College from June 2017 to December 2018,and complied with diagnosis criteria of pulmonary infection in clinical examinations,imaging examinations and laboratory tests.A total of 75 MHD patients without pulmonary infection or other site infection in the same period were selected as the non-infection group.General data and clinical examination data of all the above patients were collected,including age,sex,body mass index,primary disease,blood routine,blood biochemistry,parathyroid hormone,C-reactive protein (CRP),PCT and so on.Retrospective analysis was done on the data after enrollment.Results (1) Compared with the non-infection group,the levels of albumin and total cholesterol in the infection group were significantly lower,while the levels of WBC,neutrophil percentage,PCT and CRP were significantly higher (P<0.05).(2) Multivariate Logistic regression analysis showed that PCT (OR=70.625,95%CI 13.783~361.891,P<0.05) and WBC (OR=1.435,95%CI 1.133~1.817,P<0.05) were independent risk factors for pulmonary infection in MHD patients.(3) The areas under the receiver operating characteristic curve of PCT,WBC and PCT+WBC for the combined diagnosis of maintenance hemodialysis patients with pulmonary infection were 0.880(0.828~0.932),0.717(0.638~0.797) and 0.905(0.859~0.951)(P<0.05),respectively.Conclusions PCT and WBC are independent risk factors of pulmonary infection in MHD patients.The combined detection of PCT and WBC is more effective in the diagnosis of pulmonary infection in MHD patients.
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Keywords:
- Procalcitonin /
- Leukocyte count /
- Hemodialysis /
- Pulmonary infection /
- Combined detection
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