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

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±10.5）mg/L、（0.8±0.3）μg/L;（16.5±5.8）mg/L、（1.5±0.6）μg/L;（88.7±21.7）mg/L、（6.8±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。

The Value of Clinical Examination of C-reactive Protein and D-dimer in Patients with Acute Leukemia and Infection

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 selected. 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, disseminated 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 coagulation group were the highest, and those of the disseminated intravascular coagulation group were the lowest, the differences between the three groups were statistically significant（P0.05）. By the C-reactive protein（CRP） value, the patients were stratified into patients 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（P0.05）. 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 disseminate