血清铁蛋白对感染性疾病及活动期自身免疫性疾病鉴别诊断的临床价值研究

Clinical value of serum ferritin in differential diagnosis of infectious diseases and active autoimmune diseases

摘要:

目的 探讨血清铁蛋白（SF）对于感染性疾病及活动期自身免疫性疾病鉴别诊断的价值。方法 选取天津市人民医院感染免疫科以发热为主要症状，出院主要诊断为感染或自身免疫性疾病的患者（除外合并肿瘤、缺铁性贫血及自身免疫性疾病继发感染者）112例，分为感染组52例及自身免疫性疾病组60例。回顾性分析两组患者纤维蛋白原（FIB）、血小板计数（PLT）、C反应蛋白（CRP）、降钙素原（PCT）、SF等炎性指标水平。结果 两组患者FIB、PLT、CRP水平比较，差异无统计学意义（P?>0.05）；两组患者PCT、SF水平比较，差异有统计学意义（P?<0.05），感染组患者PCT水平较自身免疫性疾病组患者升高（P?<0.05）；自身免疫性疾病组患者SF水平较感染组患者升高（P?<0.05）。SF对自身免疫性疾病活动期诊断价值的受试者操作特征（ROC）曲线下面积为0.829。结论 活动期自身免疫性疾病患者SF水平较感染性疾病患者升高更明显，对活动期结缔组织病及感染性疾病有较大的参考意义。

Abstract:

Objective To explore the value of serum ferritin (SF) in differential diagnosis of infectious diseases and active autoimmune diseases. Methods Totally 112 cases with fever and autoimmune diseases (except those complicated with tumors, iron deficiency anemia and secondary infections of autoimmune diseases) admitted to our hospital from March 2015 to March 2017 were selected into the clinical data. The patients were divided into infection group (52 cases) and autoimmune disease group (60 cases). The levels of fibrinogen (FIB), platelet count (PLT), C-reactive protein (CRP), procalcitonin (PCT), serum ferritin and other inflammatory indicators were analyzed. Results There was no significant difference in fibrinogen, platelet count and C- reactive protein level between the two groups (P?>?0.05). The PCT level of the infected group was higher than that of the active autoimmune disease patients [(2.35?±?8.54) ng/ml VS (0.21?±?0.16) ng/ml, P?