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目的评价降钙素原(PCT)在系统性红斑狼疮(SLE)活动和SLE非活动合并全身性感染中的鉴别诊断作用。方法入选32例SLE活动和25例SLE非活动伴全身性感染患者,入选第1d体温均超过38℃。入选第1d测定各项炎症指标,采用魏氏法测定血沉(ESR)、速率散射比浊法检测C反应蛋白(CRP),同时采用双抗体夹心免疫荧光法检测PCT。记录患者入选第1d最高体温、白细胞和中性粒细胞计数,记录患者转归、SLEDAI评分。结果SLE非活动伴全身性感染者PCT(2.61±2.36ng/ml)和CRP(78.8±25.6mg/L)明显高于SLE活动者(0.51±0.32ng/ml,50.5±27.8mg/L),二者之间差异具有统计学意义(P=0.002,P=0.026)。SLE疾病活动者SLEDAI评分显著高于SLE不活动伴全身感染者(P=0.001)。结论(1)降钙素原鉴别系统性红斑狼疮活动和系统性红斑狼疮伴全身感染的准确性较传统炎症指标高。(2)SLEDAI评分可有效判断SLE疾病活动。(3)降钙素原诊断系统性红斑狼疮合并全身性感染的敏感性、特异性较传统炎症指标高,诊断正确率高。
Objective To evaluate the differential diagnosis of procalcitonin (PCT) in patients with systemic lupus erythematosus (SLE) and non-active systemic SLE infection. Methods Thirty-two SLE patients and 25 SLE non-active patients with systemic infection were enrolled in this study. The body temperature of the first day was higher than 38 ℃. Inflammatory markers were measured on day 1d, ESR was measured by Weismann method, C-reactive protein (CRP) was measured by rate nephelometry, and PCT was detected by double antibody sandwich immunofluorescence. Patients were enrolled in the 1st day of the highest temperature, leukocyte and neutrophil count, record patient outcome, SLEDAI score. Results The levels of PCT (2.61 ± 2.36ng / ml) and CRP (78.8 ± 25.6mg / L) were significantly higher in SLE inactive patients with systemic infection than in SLE patients (0.51 ± 0.32ng / ml, 50.5 ± 27.8mg / L) The difference between the two was statistically significant (P = 0.002, P = 0.026). The SLEDAI score was significantly higher in SLE disease activators than in those with SLE inactivity (P = 0.001). Conclusions (1) The procalcitonin to distinguish systemic lupus erythematosus activity and systemic lupus erythematosus with systemic infection accuracy than traditional inflammatory indicators. (2) SLEDAI score can effectively determine the SLE disease activity. (3) procalcitonin in the diagnosis of systemic lupus erythematosus with systemic infection sensitivity, specificity higher than the traditional indicators of inflammation, the diagnosis of high accuracy.