C反应蛋白和D-二聚体对急性白血病伴感染患者的临床检查价值

摘要

目的：探讨C反应蛋白和D-二聚体对急性白血病伴感染患者的临床检查价值。方法选取该院血液科2011年1月—2013年12月诊断为急性白血病的住院病人，诊断为有感染的患者定义为感染组40例；诊断为弥漫性血管内凝血的患者为弥漫性血管内凝血组40例；同时有感染与弥漫性血管内凝血的患者归为感染+弥漫性血管内凝血组40例。测取各组C反应蛋白和D-二聚体数值。结果感染组、弥漫性血管内凝血组及感染+弥漫性血管内凝血组C反应蛋白和D-二聚体分别为[（42.8依10.5)mg/L、（0.8依0.3)μg/L；（16.5依5.8)mg/L、（1.5依0.6)μg/L；（88.7依21.7)mg/L、（6.8依1.7)μg/L]，C反应蛋白和D-二聚体以联合组最高，弥漫性血管内凝血组最低，三组的差异有统计学意义（P<0.05)；以C反应蛋白[（<10 mg/L)、(10≤，<100 mg/L)、(≥100 mg/L)]进行分层，CRP≥100 mg/L的人群中，发生DIC比例及血中D-二聚体值最高，而C反应蛋白<10 mg/L的人群中，发生DIC比例及血中D-二聚体值最低，差异有统计学意义（P<0.05)。结论该研究认为急性白血病病人普遍存在感染和异常凝血，可以C反应蛋白和D-二聚体作为检测指标，判断患者是否有发生弥漫性血管内凝血与感染的风险。%Objective To evaluate the value of clinical examination of C-reactive protein and D-dimer in acute leukemia patients with infection. Methods The inpatients diagnosed with acute leukemia in the Department of Hematology of our hospital were se-lected. Those acute leukemia patients complicated by infection were set as the infection group(40 cases), those complicated by dis-seminated intravascular coagulation(DIC) were set as the disseminated intravascular coagulation group(40 cases), and those compli-cated by infection and DIC were set as the infection and disseminated intravascular coagulation group(40 cases). And the values of C-reactive protein and D-dimer of the groups were measured. Results The value of C-reactive protein of the infection group, dis-seminated intravascular coagulation group, and the infection and disseminated intravascular coagulation group was (42.8±10.5)mg/L, (16.5±5.8)mg/L,(88.7±21.7)mg/L, respectively, and the value of D-dimer of the three groups was (0.8±0.3)μg/L,(1.5±0.6)μg/L, (6.8±1.7)μg/L, respectively, the value of C-reactive protein and D-dimer of the infection and disseminated intravascular coagula-tion group were the highest, and those of the disseminated intravascular coagulation group were the lowest, the differences between the three groups were statistically significant (P<0.05). By the C-reactive protein (CRP) value, the patients were stratified into pa-tients with CRP value <10 mg/L, patients with CRP value ≥10mg/L but <100mg/L and patients with CRP value ≥100mg/L. The incidence of DIC and the value of D-dimer in blood were the highest in the patients with CRP value ≥100mg/L, while those were the lowest in the patients with CRP value <10mg/L, the differences were statistically significant (P<0.05). Conclusion We believe that patients with acute leukemia have infection and abnormal blood coagulation generally, so C-reactive protein and D-dimer can be set as the detection indicators to judge whether the patients have disseminated intravascular coagulation and infection.