发热的系统性红斑狼疮患者的感染与疾病活动。

IF 2.1 Q3 RHEUMATOLOGY BMC Rheumatology Pub Date : 2024-08-14 DOI:10.1186/s41927-024-00395-6
Rasha A Abdel-Magied, Nehal W Mokhtar, Noha M Abdullah, Al-Shaimaa M Abdel-Naiem
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引用次数: 0

摘要

背景:检测降钙素原、红细胞沉降率与c反应蛋白(ESR/CRP)比值、中性粒细胞与淋巴细胞比值(NLR)、血小板与淋巴细胞比值(PLR)在系统性红斑狼疮(SLE)发热患者感染诊断中的作用,它们在区分感染和疾病活动性方面的诊断价值,以及它们与疾病活动性的相关性:研究纳入了四十名系统性红斑狼疮患者和四十名健康对照病例。疾病活动性由系统性红斑狼疮疾病活动指数2000(SLEDAI-2 K)评估,生活质量由狼疮生活质量指数(Lupus QoL)评估。细菌感染是通过临床症状和阳性培养结果检测出来的。所有患者和对照组均进行了实验室检查:全血细胞计数(CBC)、血沉、CRP 和降钙素原(PCT)。计算了 NLR、PLR 和 ESR/CRP 比率:感染性系统性红斑狼疮患者与非感染性系统性红斑狼疮患者的 PCT 差异具有统计学意义(PPCT、ESR/CRP比率和NLR为诊断感染提供了良好的诊断指标,并能区分发热的系统性红斑狼疮患者是否感染和疾病复发。
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Infection versus disease activity in systemic lupus erythematosus patients with fever.

Background: to detect the role of procalcitonin, erythrocyte sedimentation rate to c-reactive protein (ESR/CRP) ratio, neutrophils-to-lymphocyte ratio (NLR), and platelets-to-lymphocyte ratio (PLR) in the diagnosis of infection in systemic lupus erythematosus (SLE) patients with fever, their diagnostic value to differentiate between infection and disease activity, and their correlation with disease activity.

Methods: Forty SLE patients and forty healthy control cases were included in the study. Disease activity was assessed by the Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2 K), and quality of life was assessed by Lupus QoL. A bacterial infection was detected by clinical symptoms and positive culture results. Laboratory tests were done for all patients and controls: complete blood count (CBC), ESR, CRP, and procalcitonin (PCT). NLR, PLR, and ESR/CRP ratios were calculated.

Results: There was a statistically significant difference between infected SLE patients and non-infected SLE patients regarding PCT (p < 0.001), ESR (p = 0.002), CRP (p = 0.005), ESR/CRP ratio (0.002), and NLR (p = 0.023). PCT, ESR, CRP, and NLR were positively correlated with the presence of infection in SLE patients, while the ESR/CRP ratio was negatively correlated. There was no significant correlation with the SLEDAI-2 K score. Logistic regression analysis revealed that PCT was the best significant predictor of infection (OR 224.37, 95% CI 8.94-5631.35). PCT was a good predictor of infection, with a cut-off value of 0.90 ng/ml, which gave the best combination of sensitivity (84.62%) and specificity (85.71%).

Conclusion: PCT, ESR/CRP ratio, and NLR provide good diagnostic markers for the diagnosis of infection and can distinguish between infection and disease flare in SLE patients with fever.

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来源期刊
BMC Rheumatology
BMC Rheumatology Medicine-Rheumatology
CiteScore
3.80
自引率
0.00%
发文量
73
审稿时长
15 weeks
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