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目的探究血清降钙素原(PCT)水平在系统性红斑狼疮(SLE)活动与合并细菌感染中的鉴别诊断价值。方法收集中南大学湘雅医院64例SLE伴发热住院患者,其中SLE活动期患者44例,SLE合并细菌感染患者20例,另选取SLE稳定期不发热患者20例作为对照,同时检测血样本PCT值、C反应蛋白(CRP)值、血沉及白细胞计数。结果SLE合并细菌感染组血清PCT、CRP水平明显高于SLE活动组,差异有统计学意义,以血清PCT≥0.5 ng/ml为诊断细菌感染阳性阈值,PCT对SLE合并细菌感染的发热患者诊断敏感性和特异性分别为80.0%、81.8%,阳性预测值、阴性预测值分别为66.7%、90.0%。结论血清PCT水平的升高对SLE发热患者是否合并细菌感染具有良好特异性和敏感性,对感染的早期诊断具有较好的临床参考价值。
Objective To investigate the differential diagnosis value of serum procalcitonin (PCT) level in systemic lupus erythematosus (SLE) activity and combined bacterial infection. Methods Sixty-four patients with SLE with fever were recruited from Xiangya Hospital of Central South University. Among them, 44 patients were active SLE patients and 20 patients were SLE patients with bacterial infection. Another 20 patients with stable SLE patients without fever were selected as controls. , C-reactive protein (CRP) value, erythrocyte sedimentation rate and white blood cell count. Results The serum levels of PCT and CRP in patients with SLE complicated with bacterial infection were significantly higher than those in patients with SLE, the difference was statistically significant. Serum PCT≥0.5 ng / ml was the positive threshold for diagnosis of bacterial infection, and PCT was sensitive to fever in SLE patients with bacterial infection The specificity and specificity were 80.0% and 81.8% respectively. The positive predictive value and negative predictive value were 66.7% and 90.0% respectively. Conclusions The elevated serum PCT level has a good specificity and sensitivity for the detection of bacterial infection in patients with SLE fever and has good clinical value for early diagnosis of infection.