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[某些炎症标志物在HIV感染患者急性腹膜炎诊断中的作用]

[The role of some inflammatory markers in diagnosis of acute peritonitis in patients with HIV infection].

作者信息

Faller A P, Kurnosov A V, Sundukov A V

机构信息

Infectious Diseases Hospital No.2, Moscow, Russia.

Russian Biotechnological University, Moscow, Russia.

出版信息

Khirurgiia (Mosk). 2024(12):29-37. doi: 10.17116/hirurgia202412129.

Abstract

OBJECTIVE

To evaluate the effectiveness of leukocyte, NLR, procalcitonin and C-reactive protein as the markers of acute peritonitis in patients with HIV-infection.

MATERIAL AND METHODS

The study included 83 HIV-infected patients with various diseases complicated by acute peritonitis. Leukocytes, procalcitonin and C-reactive protein, as well as immune status and viral load were determined in peripheral blood before surgery. NLR was also estimated. Patients were divided into four groups depending on immune status. We analyzed leukocyte count, NLR, procalcitonin and C-reactive protein depending on immune deficiency and viral load.

RESULTS

Reduced immune status is followed by higher viral load. At the same time, there is a direct dependence of leukocyte count on immune status, and leukocyte count itself does not exceed the threshold values. Procalcitonin and C-reactive protein do not correlate with severity of immunodeficiency and exceed the reference values by tens of times. There is no correlation between NLR and immune status. However, threshold values of this indicator are not clear.

CONCLUSION

Leukocyte count is of minor importance in diagnosis of acute peritonitis in patients with HIV-infection. The role of NLR is not entirely clear in these patients and requires further study. Procalcitonin and C-reactive protein can be used as additional markers of acute peritonitis in HIV-positive patients.

摘要

目的

评估白细胞、中性粒细胞与淋巴细胞比值(NLR)、降钙素原及C反应蛋白作为HIV感染患者急性腹膜炎标志物的有效性。

材料与方法

该研究纳入了83例患有各种疾病并并发急性腹膜炎的HIV感染患者。术前测定外周血中的白细胞、降钙素原和C反应蛋白,以及免疫状态和病毒载量。同时计算NLR。根据免疫状态将患者分为四组。我们根据免疫缺陷和病毒载量分析白细胞计数、NLR、降钙素原和C反应蛋白。

结果

免疫状态降低伴随着更高的病毒载量。同时,白细胞计数与免疫状态呈直接相关,且白细胞计数本身未超过阈值。降钙素原和C反应蛋白与免疫缺陷的严重程度无关,且超出参考值数十倍。NLR与免疫状态之间无相关性。然而,该指标的阈值尚不清楚。

结论

白细胞计数在HIV感染患者急性腹膜炎的诊断中作用较小。NLR在这些患者中的作用尚不完全清楚,需要进一步研究。降钙素原和C反应蛋白可作为HIV阳性患者急性腹膜炎的附加标志物。

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