降钙素原及C反应蛋白联合检测在卒中相关性肺炎诊断及病情评估中的价值

目的 探讨降钙素原(PCT)和C反应蛋白(CRP)在卒中相关性肺炎(SAP)诊断、病情和预后评估中的价值.方法 选取2012年1月至2016年1月武警安徽总队医院收治的186例SAP患者为观察组,选取同期未发生肺炎的急性脑卒中患者175例为对照组.检测两组患者入院当日和发病后第7天的血清PCT、CRP水平,统计分析两组患者PCT、CRP水平的差异;同时根据美国国立卫生研究院卒中量表(NIHSS)评分将观察组患者分为轻型(NIHSS≤6分)、中型(6分14分)3型,比较3型别患者血清PCT、CRP水平的变化.结果 观察组患者入院后当日PCT和CRP水平(6.73±1.21)ng/mL、(26.83±2.62)mg/L]均高于对照组(0.51±0.12)ng/mL、(9.52±0.81)mg/L],差异有统计学意义(P<0.05),发病后第7天PCT仍高于对照组,差异有统计学意义(P<0.05),而CRP水平与对照组比较差异无统计学意义(P>0.05);观察组患者入院当日与发病后第7天相比PCT水平差异无统计学意义(P>0.05),而入院当日观察组CRP水平高于发病后第7天,差异有统计学意义(P<0.05);入院当日观察组轻、中、重3型患者血清PCT和CRP水平依次升高,发病后第7天,PCT水平亦依次升高,差异均有统计学意义(P<0.05),但CRP水平差异无统计学意义(P>0.05).结论 SAP患者血清PCT及CRP联合检测可作为SAP早期诊断、病情和预后评估的较好临床指标.

Value of joint detection of procalcitonin and CRP in diagnosis and evaluation of stroke-associated pneumonia

Objective To explore the value of joint detection of procalcitonin ( PCT) and C-reactive protein ( CRP) in the diagno-sis, pathogenic condition and prognosis evaluation of stroke-associated pneumonia (SAP). Methods From Jan 2012 to Jan 2016, 186 ca-ses of SAP patients treated in our hospital were enrolled as the study group, and 175 cases of acute stroke patients without pneumonia were simultaneously enrolled as the control group. The serum PCT and CRP levels on admission and at 7 days after attack in all patients were de-tected and the differences between the two groups were compared. According to their National Institute of Health stroke scale ( NIHSS ) scores, the patients in the study group were further divided into the mild subgroup (NIHSS score≤6), the moderate subgroup (6 < NIHSS score≤14) and the severe subgroup (NIHSS score >14). And changes of serum PCT and CRP levels among the three subgroups were also compared. Results In the study group, the serum PCT and CRP levels on admission (6. 73 ± 1. 21) ng/mL, (26. 83 ± 2. 62) mg/L] were significantly higher than those in the control group (0. 51 ± 0. 12) ng/mL, (9. 52 ± 0. 81) mg/L;P<0. 05], and the PCT level at 7 days after attack was still significantly higher than that in the control group ( P<0. 05 ) , but there was no significant difference in the CRP level between them at the moment (P>0. 05). The PCT levels in the study group were of no significant difference between on admission and at 7 days after attack (P>0. 05), but the CRP levels in the study group on admission were significantly higher than those at 7 days after at-tack (P<0. 05). On admission, the CRP and PCT levels in the mild, moderate and severe groups increased successively, and at 7 days af-ter attack, the differences of PCT levels among the three subgroups became significant (P<0. 05), but the differences of CRP levels were not significant (P>0. 05). Conclusion The joint detection of serum PCT and CRP levels in SAP patients would be a better clinical marker for the early diagnosis, pathogenic condition and prognosis evaluation of SAP.