目的：探讨伊立替康化疗后腹泻患者血清降钙素原（procalcitonin，PCT）和C反应蛋白（C-reactive protein，CRP）的水平。方法：对伊立替康化疗后85例腹泻患者和63例无腹泻患者行血清PCT和CRP水平测定。结果：根据WHO腹泻分级，使用伊立替康治疗后，无腹泻者0级（对照组），腹泻者Ⅰ～Ⅳ级（试验组），对照组PCT、CRP第2天分别为（0.29±0.17）ng/mL、（6.06±1.85） mg/L，第4天分别为（0.28±0.15）ng/mL、（5.80±1.82）mg/L，试验组根据分级从低到高第2天为Ⅰ级（0.30±0.18）ng/mL、（6.12±1.16） mg/L，Ⅱ级（0.36±0.20）ng/mL、（6.20±1.68）mg/L，Ⅲ级（1.24±0.22）ng/mL、（22.62±4.55）mg/L，Ⅳ级（2.15±0.26）ng/mL、（31.26±5.23） mg/L，第4天为Ⅰ级（0.30±0.14）ng/mL、（5.94±1.14）mg/L，Ⅱ级（0.34±0.18）ng/mL、（6.15±1.55）mg/L，Ⅲ级（2.00±0.22）ng/mL、（30.52±4.74）mg/L，Ⅳ级（2.40±0.28）ng/mL、（38.67±5.68）mg/L，对照组和试验组腹泻Ⅰ级、Ⅱ级PCT、CRP水平差异无统计学意义（P>0.05），对照组、试验组腹泻Ⅰ级、Ⅱ级均与Ⅲ级、Ⅳ级PCT、CRP差异有统计学意义（P<0.05）。结论：通过检测伊立替康化疗后腹泻患者血清PCT和CRP，早期评估腹泻分级，可判断是否存在肠源性细菌感染，对指导早期抗感染治疗有一定临床价值。%Objective:To investigate procalcitonin and C-reactive protein levels in diarrheal patients who underwent irinotecan che-motherapy. Methods:Procalcitonin and C-reactive protein were detected among 85 diarrheal and 63 non-diarrheal patients after irinote-can chemotherapy. Results:According to WHO classification, patients without diarrhea are classified as grade 0, whereas patients with diarrhea can be classified as gradesⅠ-Ⅳ. In grades 0,Ⅰ,Ⅱ,Ⅲ, andⅣpatients, the levels of procalcitonin were 0.29 ± 0.17, 0.30 ± 0.18, 0.36 ± 0.20, 1.24 ± 0.22, and 2.15 ± 0.26 ng/mL on the second day, respectively. However, on the fourth day, the procalcitonin lev-els were 0.28 ± 0.15, 0.30 ± 0.14, 0.34 ± 0.18, 2.00 ± 0.22, and 2.40 ± 0.28 ng/mL, respectively. Moreover, in grades 0,Ⅰ,Ⅱ,Ⅲ, andⅣ, the levels of C-reactive protein were 6.06 ± 1.85, 6.12 ± 1.16, 6.20 ± 1.68, 22.62 ± 4.55, and 31.26 ± 5.23 mg/L on the second day, respectively. On the fourth day, the C-reactive protein levels were 5.80 ± 1.82, 5.94 ± 1.14, 6.15 ± 1.55, 30.52 ± 4.74, and 38.67 ± 5.68 mg/L, respectively. No significant difference was found between the procalcitonin and C-reactive protein levels of stagesⅠandⅡpa-tients (P>0.05), but a significant difference was found between stagesⅠ, andⅡpatients and stagesⅢandⅣpatients (P<0.05). Con-clusion: Monitoring levels of procalcitonin and C-reactive protein may be helpful in the early evaluation of the severity of diarrhea. This process has prognostic effect and can be used to assess whether patients have enterogenous bacterial infection. Monitoring the lev-els of these proteins has certain clinical value and can be used to guide early anti-infection therapy.
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