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初始降钙素原水平可预测非霍奇金淋巴瘤伴发热性中性粒细胞减少症患者的感染及其预后。

Initial procalcitonin level predicts infection and its outcome in patients with non-Hodgkin lymphoma with febrile neutropenia.

作者信息

Liu Xiao, Wang Dao Feng, Fang Yi, Ye Wen Feng, Liu Shu, Lou Ning

机构信息

Department of Critical Care Medicine, Sun Yat-sen University Cancer Center and State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center of Cancer Medicine , Guangzhou , China.

出版信息

Leuk Lymphoma. 2015 Jan;56(1):85-91. doi: 10.3109/10428194.2014.911864. Epub 2014 Jun 17.

Abstract

We explored whether initially determined procalcitonin (PCT) levels could facilitate assessment of the risks of infection and death due to treatment failure in patients with non-Hodgkin lymphoma (NHL) with newly developed febrile neutropenia (FN). In the 212 examined episodes, the initial PCT value was markedly higher in patients with microbiologically documented infection (MDI) or clinically documented infection compared with patients with fevers of unknown origin (p < 0.001 for both). Patients with initial PCT values ≥ 0.50 ng/mL were at high risk of MDI (sensitivity 83.5%, specificity 77.2%). A significantly elevated PCT level was closely correlated with patient mortality (area under the curve [AUC] 0.864, 95% confidence interval [CI] 0.811-0.907, p < 0.001) and patients' admission to the intensive care unit (AUC 0.926, 95% CI 0.882-0.957, p < 0.001). In conclusion, the initially determined PCT value was a useful marker for identifying infection and predicting outcome in patients with NHL with FN.

摘要

我们探讨了最初测定的降钙素原(PCT)水平是否有助于评估新发生发热性中性粒细胞减少症(FN)的非霍奇金淋巴瘤(NHL)患者因治疗失败导致感染和死亡的风险。在212例检查的病例中,与不明原因发热患者相比,微生物学证实感染(MDI)或临床证实感染患者的初始PCT值明显更高(两者p均<0.001)。初始PCT值≥0.50 ng/mL的患者发生MDI的风险很高(敏感性83.5%,特异性77.2%)。PCT水平显著升高与患者死亡率密切相关(曲线下面积[AUC] 0.864,95%置信区间[CI] 0.811 - 0.907,p < 0.001)以及患者入住重症监护病房(AUC 0.926,95% CI 0.882 - 0.957,p < 0.001)。总之,最初测定的PCT值是识别NHL合并FN患者感染和预测预后的有用标志物。

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