D-二聚体、C反应蛋白、降钙素原水平监测对判断化疗后出现骨髓抑制的恶性肿瘤患者合并感染的发生与否及评估其病情严重程度和预后的指导意义

The Monitoring of D-Dimer, C-Reactive Protein and Procalcitonin Levels Is of Guiding Significance in Judging the Occurrence of Co-Infection and Evaluating the Severity and Prognosis of Malignant Tu-mor Patients with Bone Marrow Suppression after Chemotherapy

摘要: 目的：研究D-二聚体、C反应蛋白、降钙素原的动态水平对判断化疗后出现III~IV度骨髓抑制的恶性肿瘤患者合并感染的发生与否及评估其病情严重程度和预后的指导意义。方法：测定所有52例患者化疗后出现III~IV度骨髓抑制的第1，2，3，4天至出现感染期间的D-二聚体、C反应蛋白、降钙素原。按是否感染将患者分为非感染组(32例)和感染组(20例)，分别进行三项指标的连续监测，对检测结果进行统计学分析。结果：未感染组与感染组第1天检测的D-二聚体、C反应蛋白、降钙素原水平比较无统计学意义；未感染组第2，3，4天及出院前最后一次检测的D-二聚体、C反应蛋白、降钙素原水平明显高于感染组，有统计学意义。结论：D-二聚体、C反应蛋白、降钙素原水平与骨髓抑制后发生的合并感染关系密切，其持续高水平提示合并感染发生的可能，且病情较重，预后较差。因此D-二聚体、C反应蛋白、降钙素原水平可作为判断是否发生合并感染的指标。

Abstract: Objective: To study the D-dimer, c-reactive protein, calcitonin original dynamic level of judgment (III~IV) degrees after chemotherapy in patients with malignant tumor of bone marrow suppression merge infection and evaluate the significance of disease severity and prognosis. Methods: Determi-nation of all 52 cases III~IV degrees after chemotherapy in patients with bone marrow suppression of 1, 2, 3, 4 days to appear during the infection of D-dimer, c-reactive protein, calcitonin original. Pa-tients were divided into non-infected group (32 cases) and infected group (20 cases) according to whether or not they were infected. Continuous monitoring of the three indicators was conducted, and the test results were statistically analyzed. Results: The levels of D-dimer, C-reactive protein and procalciton in detected in the uninfected group and the infected group on day 1 were not statis-tically significant. The levels of D-dimer, C-reactive protein and procalcitonin detected in the unin-fected group at day 2, 3, 4 and the last time before discharge were significantly higher than those in the infected group, with statistical significance. Conclusion: The levels of D-dimer, C-reactive protein and procalciton in are closely related to the occurrence of comorbidity infection after bone marrow suppression. Therefore, the levels of D-dimer, C-reactive protein and procalcitonin can be used as indicators to determine whether co-infection occurs.