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降钙素原在造血干细胞移植患者细菌感染中的临床应用价值

Clinical utility of procalcitonin in bacterial infections in patients undergoing hematopoietic stem cell transplantation.

作者信息

Bansal Amit, Jeyaraman Preethi, Gupta S K, Dayal Nitin, Naithani Rahul

机构信息

Pharmaceutical Sciences and Research University New Delhi, India.

Division of Hematology and Bone Marrow Transplant, Max Super-Speciality Hospital Saket, New Delhi, India.

出版信息

Am J Blood Res. 2020 Dec 15;10(6):339-344. eCollection 2020.

PMID:33489442
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7811896/
Abstract

BACKGROUND

Infections are major contributor to morbidity and mortality in patients undergoing bone marrow transplant (BMT).

OBJECTIVE

To assess role of serum procalcitonin (PCT) as a useful biomarker for the infections and outcomes in these patients.

METHODS

Retrospective observational study.

RESULTS

Total 47 patients with febrile episodes were enrolled. Twenty patients underwent autologous BMT and 27 underwent allogeneic BMT. Bacterial infections were documented in 18/47 (38%) patients. Forty patients were neutropenic. The median fever duration was 10 days (range 3-30 days) in positive procalcitonin level group whereas it was 4 days (range 1-18) in negative group. This was statistically significant (P=0.000). Procalcitonin levels were high in 8/9 episodes of sepsis (P=0.029). Intensive care unit transfers and death were significantly higher in PCT positive group as compared to PCT negative group.

CONCLUSION

Serum procalcitonin levels provide prognostic information of worse outcome in patients undergoing HSCT.

摘要

背景

感染是接受骨髓移植（BMT）患者发病和死亡的主要原因。

目的

评估血清降钙素原（PCT）作为这些患者感染及预后有用生物标志物的作用。

方法

回顾性观察研究。

结果

共纳入47例有发热发作的患者。20例接受自体BMT，27例接受异体BMT。18/47（38%）例患者有细菌感染记录。40例患者为中性粒细胞减少。降钙素原水平阳性组的中位发热持续时间为10天（范围3 - 30天），而阴性组为4天（范围1 - 18天）。这具有统计学意义（P = 0.000）。9例脓毒症发作中有8例降钙素原水平升高（P = 0.029）。与降钙素原阴性组相比，降钙素原阳性组转入重症监护病房及死亡的比例显著更高。

结论

血清降钙素原水平为接受造血干细胞移植（HSCT）患者预后较差提供了预后信息。