[1]马俊娥,崔湘铧,刘 芮,等.新型冠状病毒肺炎患者血浆CRP,PCT和IL-6水平检测的临床诊断价值[J].现代检验医学杂志,2021,36(05):105-109.[doi:10.3969/j.issn.1671-7414.2021.05.023]
 MA Jun-e,CUI Xiang-hua,LIU Rui,et al.Diagnostic Value of Determination of Plasma CRP, PCT andIL-6 Levels in Patients with COVID-19[J].Journal of Modern Laboratory Medicine,2021,36(05):105-109.[doi:10.3969/j.issn.1671-7414.2021.05.023]
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新型冠状病毒肺炎患者血浆CRP,PCT和IL-6水平检测的临床诊断价值()
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《现代检验医学杂志》[ISSN:/CN:]

卷:
第36卷
期数:
2021年05期
页码:
105-109
栏目:
新型冠状病毒肺炎检验专题
出版日期:
2021-10-14

文章信息/Info

Title:
Diagnostic Value of Determination of Plasma CRP, PCT andIL-6 Levels in Patients with COVID-19
文章编号:
1671-7414(2021)05-105-05
作者:
马俊娥1崔湘铧1刘 芮1韩 欢1邬开朗2刘 芳2祝成亮1
(1. 武汉大学人民医院检验科, 武汉 430060; 2 武汉大学病毒学国家重点实验室, 武汉 430072)
Author(s):
MA Jun-e1 CUI Xiang-hua1 LIU Rui1 HAN Huan1 WU Kai-lang2 LIU Fang2 ZHU Cheng-liang1
(1.Department of Clinical Laboratory, Renmin Hospital of Wuhan University, Wuhan 430060, China;2.State Key Laboratory of Virology of Wuhan University, Wuhan 430072,China)
关键词:
新型冠状病毒肺炎C反应蛋白降钙素原白介素-6
分类号:
R373.1;R446.11
DOI:
10.3969/j.issn.1671-7414.2021.05.023
文献标志码:
A
摘要:
目的 评估单独及联合检测新型冠状病毒肺炎(coronavirus disease-2019,COVID-19)患者血浆C反应蛋白(C reactive protein,CRP)、降钙素原(procalcitonin,PCT)和白介素-6(interleukin-6,IL-6)水平的临床诊断价值。方法 选取2020年1 月1日~2月2日期间武汉大学人民医院COVID-19确诊患者96例,其中普通型41例,重型45例和危重型10例,另选40例健康者作为对照组,收集96例患者的CRP,PCT和IL-6以及40例健康者的CRP和PCT检测结果并绘制ROC曲线。结果 与对照组相比,COVID-19组患者的CRP[0.40(0.40~0.57)mg/L vs 60.35(21.00~108.48mg/L)]和PCT[0.05(0.04~0.07)ng/ml vs 0.09(0.05~0.20)ng/ml]水平显著增高,差异有统计学意义(Z=-4.662和-9.202,均P<0.001)。在COVID-19患者中,普通型患者的CRP[36.80(10.20~67.40)mg/L vs 84.90(49.25~134.65)mg/L,94.10(122.18~198.05)mg/L],PCT[0.06(0.04~0.09)ng/ml vs 0.12(0.07~0.27)ng/ml,0.22(0.05~0.47)ng/ml]水平明显低于重型、危重型患者,差异有统计学意义(Z=-4.576~-2.48, 均P<0.05)。普通型患者的IL-6[8.42(1.73~20.59)pg/ml vs 73.65(18.03~311.39)pg/ml]水平低于危重型,差异均有统计学意义 (Z=3.118,P<0.05);ROC曲线显示PCT和CRP诊断COVID-19价值较高,诊断重型和危重型COVID-19患者,CRP的价值最高,且三个指标联合检测可以提高诊断效能;诊断危重型COVID-19患者,IL-6有较高的预测价值。结论 血浆CRP,PCT和IL-6水平可能是诊断COVID-19的潜在生物标志物,并且其血浆水平可以评估COVID-19的严重程度,三指标联合检测可以提高评估效能,对COVID-19的临床诊断和治疗具有重要的参考价值。
Abstract:
Objective To evaluate the clinical diagnostic value of plasma CRP, PCT and IL-6 levels in patients with COVID-19alone and in combination. Methods A total of 96 confirmed COVID-19 patients were selected from the Renmin Hospital ofWuhan University during January 1, 2020 and February 2, 2020,including 41 cases of moderate type, 45 cases of severe type and10 cases of critical type,another 40 healthy subjects were selected as the control group.The detection results of CRP, PCT andIL-6 in 96 patients and CRP, PCT in 40 healthy subjects were collected and ROC curves were drawn. Results Compared withthe control group, the levels of CRP[0.40(0.40~0.57)mg/L vs 60.35(21.00~108.48mg/L)] and PCT[0.05(0.04~0.07)ng/ml vs 0.09(0.05~0.20)ng/ml] in COVID-19 group were significantly increased, the differences were statistically significant(Z=-9.202,-4.662, all P<0.01). Among COVID-19 patients, the CRP[36.80(10.20~67.40)mg/L vs 84.90(49.25~134.65)mg/L,94.10(122.175~198.05)mg/L] and PCT[0.06(0.04~0.09)ng/ml vs 0.12(0.07~0.27)ng/ml,0.22(0.05~0.47)ng/ml] levels of moderate patients were significantly lower than those of severe and critical patients the differences werestatistically significant(Z=-4.576~-2.480, all P<0.05). The level of IL-6 in the moderate type was lower than that in the criticaltype [(8.42(1.73~20.59) pg/ml vs 73.65(18.03~311.39)pg/ml)], all differences were statistically significant (Z=3.118, P<0.05).The ROC curve showed that PCT and CRP had high value in the diagnosis of COVID-19, and CRP had the highest value in the evaluation of patients with severe and critical COVID-19, and the combined detection of the three indexes couldimprove the evaluation efficiency. IL-6 had a high predictive value in the evaluation of critical COVID-19 patients.Conclusion CRP, PCT and IL-6 levels may be potential biomarkers for the diagnosis of COVID-19 and can be used to assess the severity ofCOVID-19, the combined diagnosis of three indicators may improve the diagnostic efficiency ,providing important reference valuefor the clinical diagnosis and treatment of COVID-19.

参考文献/References:

[1] LU Hongzhou, STRATTON C W, TANG Yiwei.Outbreak of pneumonia of unknown etiology in Wuhan,China: The mystery and the miracle[J]. Journal ofMedical Virology, 2020, 92(4): 401-402.
[2] GARHAM CARLOS W,DELA CRUZ C S, CAOBin, et al. Novel Wuhan (2019-nCoV) coronavirus[J].American Journal of Respiratory and Critical CareMedicine, 2020, 201(4): P7-P8.
[3] GORBALENYA A E,BAKER S C,BARIC R S,et al. The species severe acute respiratory syndromerelatedcoronavirus : classifying 2019-nCoV andnaming it SARS-CoV-2[J]. Nature Microbiology, 2020,5(4) : 536-544.
[4] World Health Organization. Summary of probable SARScases with onset of illness from 1 November 2002 to 31July 2003 [EB/OL]. https://www.who.int/csr/sars/country/table2004_04_21/en/. Accessed March 6, 2021.
[5] World Health Organization. MERS Situation Update,January 2020 Epidemic and Pandemic-ProneDiseases[EB/OL].http://www.emro.who.int/pandemicepidemic-diseases/mers-cov/mers-situationupdate-January-2020.html. Accessed March 6, 2021.
[6] JI Wei, WANG Wei, ZHAO Xiaofeng, et al. Crossspeciestransmission of the newly identified coronavirus2019-nCoV[J]. Journal of Medical Virology, 2020,92(4): 433-440.
[7] DE WIT E, VAN DOREMALEN N, FALZARANO D,et al. SARS and MERS: recent insights into emergingcoronaviruses[J]. Nature Reviews Microbiology, 2016,14(8): 523-534.
[8] CHEN Nanshan, ZHOU Min, DONG Xuan, et al.Epidemiological and clinical characteristics of 99 casesof 2019 novel coronavirus pneumonia in Wuhan, China:a descriptive study[J]. The Lancet, 2020, 395(10223) :507-513.
[9] 梁颖,曾斯敏,刘婷,等.病毒特异性抗体检测在新型冠状病毒肺炎诊断中的应用价值[J].武汉大学学报( 医学版),2020,41(5):693-696.LIANG Ying, ZENG Simin, LIU Ting, et al. Clinicalapplication value of novel coronavirus antibodydetection in the diagnosis of COVID-19 [J]. MedicalJournal of Wuhan University (Medical Edition), 2020,41(5): 693-696.
[10] 陈星, 区静怡, 黄颖, 等. 多种血液学指标在新型冠状病毒肺炎中的诊断价值 [J] 检验医学, 2020, 35(4):295-299.CHEN Xing, OU Jingyi, HUANG Ying, et al.Diagnostic roles of several parameters in corona virusdisease 2019 [J]. Laboratory Medicine, 2020, 35(4):295-299.
[11] YE Qing, WANG Bili, MAO Jianhua. The pathogenesisand treatment of the `Cytokine Storm’ in COVID-19[J].Journal of Infection, 2020, 80(6): 607-613.
[12] 国家卫生健康委员会办公厅. 新型冠状病毒肺炎诊疗方案( 试行第五版修订版)[EB/OL].(2020-02-08)
[2020-02-23]. http://www.nhc.gov.cn/xcs/zhengcwj/202002/d4b895337e19445f8d728fcaf1e3e13a/files/ab6bec7f93e64e7f998d802991203cd6.pdf.General Office for National Health Commission. Theguideline of diagnosis and treatment of COVID-19(Pilot Release 5 Revision)[EB/OL]. (2020-02-08)
[2020-02-23]. http://www.nhc.gov.cn/xcs/zhengcwj/202002/d4b895337e19445f8d728fcaf1e3e13a/files/ab6bec7f93e64e7f998d802991203cd6.pdf.
[13] BOGOCH I I, WATTS A, THOMAS-BACHLI A, etal. Pneumonia of unknown aetiology in Wuhan, China:potential for international spread via commercial airtravel[J]. Journal of Travel Medicine, 2020, 27(2):taaa008.
[14] 董陈颍, 杨鸿. 新型冠状病毒引起的细胞因子风暴及中医药治疗[J]. 中华中医药学刊, 2020, 38(7): 15-18.DONG Chenying, YANG Hong. Cytokine storm byCOVID-19 and treatment strategy of traditional Chinesemedicine [J]. Chinese Archives of Traditional ChineseMedicine, 2020, 38(7): 15-18.
[15] MAHALLAWI W H, KHABOUR O F, ZHANG Qibo,et al. MERS-CoV infection in humans is associatedwith a pro-inflammatory Th1 and Th17 cytokineprofile[J]. Cytokine, 2018, 104: 8-13.
[16] 周玉平,朱传新,龚娇芳,等.新冠肺炎患者临床实验室检测结果分析[J].现代检验医学杂志,2020,35(2):83-87.ZHOU Yuping, ZHU Chuanxin, GONG Jiaofang, et al.Analysis of clinical laboratory test results in patientswith novel coronavirus pneumonia [J]. Journal ofModern Laboratory Medicine,2020, 35(2): 83-87.
[17] 昌仲勇, 杨为斌, 王强, 等. 血清hs-CRP, IL-6,PCT 对新型冠状病毒肺炎患者的诊断及预后评估的临床意义[J]. 现代药物与临床, 2020, 35(3): 417-420.CHANG Zhongyong, YANG Weibin, WANG Qiang,et al. Clinical significance of serum hs-CRP, IL-6,and PCT in diagnosis and prognosis of patients withCOVID-19 [J]. Drugs & Clinic, 2020, 35(3): 417-420.

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备注/Memo

备注/Memo:
基金项目:国家科技重大专项课题(2017ZX10103005),国家自然科学基金(81672079)。
作者简介:马俊娥(1995-),女,医学硕士生,主要从事感染性疾病的临床及基础研究,E-mail:mje222@whu.edu.cn。
通讯作者:祝成亮(1980-),男,主任技师,博士生导师,主要从事感染性疾病的临床及基础研究,E-mail:xinchengzhu@163.com。
更新日期/Last Update: 1900-01-01