血清降钙素原在肺炎诊断及严重程度判断中的研究

目的:评价血清降钙素原(PCT)对肺炎诊断及严重程度评估中的应用价值。方法:本研究为前瞻性,收集肺炎患者51例,检测患者的血清PCT、C-反应蛋白(CRP)、内毒素(LPS)、白细胞(WBC)计数及白细胞介素-6(IL-6)。结果:1.痰细菌培养阳性肺炎组PCT水平较支原体肺炎或衣原体肺炎组高,差异有统计学意义(P<0.01),较病原学检测阴性肺炎组高,差异有统计学意义(P<0.01),病原学检测阴性肺炎组PCT水平较支原体肺炎或衣原体肺炎组高,差异无统计学意义(P>0.05)。2.有并发症组的PCT水平较无并发症组高,差异有统计学意义(P<0.05)。PCT水平在中高危组较低危组高,差异有统计学意义(P<0.05);PCT阳性率在中高危组较低危组高,差异有统计学意义(P<0.05)结论:血清PCT水平对肺炎的病原学诊断有一定的预测价值,而CRP、内毒素、WBC计数及IL-6组间,差异无统计学意义;血清PCT作为肺炎患者严重程度的一项评价指标可能具有一定意义。

Roles of serum procalcitonin in the diagnosis and severity evaluation of pneumonia in adult patients

Objective:To evaluate the usefulness of serum procalcitonin(PCT) level as a predictor of diagnosis in adult patients with pneumonia and to discuss the value of PCT in the severity assessment of pneumonia.Methods: It is a prospective study,in the 51 patients with pneumonia were enrolled in this trial.Patients’ data were collected,including basic information,associated diseases,imaging examination,microbiology,blood gases analysis,and CURB-65 Score(respiratory rate,blood pressure,renal function,consciousness,age).Meanwhile,the values of PCT,CRP and WBC,IL-6,endotoxin were detected within the first 24h of admission.Results: 1.The level of PCT of the group with positive sputum culture was higher than that of mycoplasma or chlamydia pneumonia group,the varies had statistics significant between the two groups(P=0.006),it is also higher than that of the patients without etiology(P=0.004).However,the levels of WBC、CRP、IL-6 and endotoxin among the groups had no significant differences(P>0.05).2.Patients with complications had a higher PCT level than those who did not.Pneumonia Severity Classification(CURB-65 Score) is an objective standard for estimating the severity of condition of pneumonia.According to this score,with 2 scores as critical value,patients was divided into two groups,using 0.1ug/L as critical values,the values of PCT were divided into two groups,significant difference was observed between mortality low group and mortality intermediate or high group(P=0.026).Conclusion: PCT may have a role to predict the etiological diagnosis in patients with pneumonia and have an advantage over CRP、endotoxin、 WBC and IL-6.The study also suggests that PCT may have a role to predict the severity in the patients with pneumonia.