血清降钙素原与C-反应蛋白联合检测在肝硬化并肺部感染患者中的诊断价值

目的 探讨血清降钙素原(procalcitonin,PCT)与C-反应蛋白(C-reactive protein,CRP)联合检测在肝硬化并肺部感染患者中的诊断价值及临床意义.方法 选取2014年8月至2016年5月在本院入院治疗的肝硬化并肺部感染患者83例作为研究对象,根据病原学检测结果将其分为肝硬化细菌致肺部感染组(观察组)42例与肝硬化非细菌致感染组(对照组)41例,另选本院同期进行体检健康者40例作为健康组,检测并记录各组PCT、CRP,并采用SPSS21.0软件对所得数据进行处理.结果 治疗前观察组PCT水平均显著高于对照组和健康组,差异具有统计学意义(均P＜0.05);治疗后观察组PCT水平略高于对照组,差异不具有统计学意义(t=1.524,P＞0.05);观察组治疗后PCT水平显著低于治疗前,差异具有统计学意义(t=11.291,P ＜0.05);对照组治疗后PCT水平略高于治疗前,差异不具有统计学意义(t=0.928,P＞0.05).治疗前观察组CRP水平均显著高于对照组和健康组,差异具有统计学意义(P＜0.05);治疗后观察组CRP水平与对照组相比差异不具有统计学意义(t=0.825,P ＞0.05);观察组治疗后CRP水平显著低于治疗前,差异具有统计学意义(t =6.032,P＜0.05);对照组治疗后CRP水平略高于治疗前,差异不具有统计学意义(t=1.853,P＞0.05).观察组患者PCT、CRP单独检测以及PCT、CRP联合检测的阳性检出率均显著高于对照组,差异具有统计学意义(t值依次为8.517、14.624、5.433,均P＜0.05).PCT、CRP联合检测的特异性、灵敏度、阳性预测值与阴性预测值均显著高于PCT、CRP单独检测,差异具有统计学意义(均P ＜0.05).结论 肝硬化患者存在肺部感染风险,通过对肝硬化患者进行血清PCT与CRP联合检测,对肺部感染疾病的早期鉴别诊断具有积极意义.

Diagnostic Value of Serum PCT and CRP in Patients with Liver Cirrhosis Complicated with Pulmonary Infection

Objective To discuss the diagnostic value and clinical significance of combined detection of serum PCT and CRP in patients with liver cirrhosis complicated with pulmonary infection.Methods A total of 83 patients with liver cirrhosis complicated with pulmonary infection were selected as the study group,according to the results of pathogenic detection,it was divided into 42 cases of pulmonary infection group(observation group) and 41 cases of non bacterial infection group(control group),and 40 healthy subjects were enrolled as healthy group.PCT and CRP in each group were detected and recorded,and the date were processed using SPSS21.0 software.Results Before treatment,the levels of PCT in the observation group were significantly higher than those in the control group and healthy group,the difference were statistically significant(all P ＜0.05).After treatment,the level of PCT in the observation group was slightly higher than that in the control group,which was not statistically significant(t =1.524,P ＞ 0.05).PCT level of the observation group was significantly lower than that before treatment (t =11.291,P ＜ 0.05).The level of PCT in the control group after treatment was slightly higher than that before treatment,and the.difference was not statistically significant(t =0.928,P ＞ 0.05).Before treatment,the levels of CRP in the observation group were significantly higher than those in the control group and healthy group (all P ＜ 0.05).The level of CRP in the observation group was not statistically significant(t =0.825,P ＞0.05) when compared with the control group.The CRP level of the observation group was significantly lower than that before treatment(t =6.032,P ＜ 0.05).The level of CRP in the control group after treatment was slightly higher than that before treatment,and the difference was not statistically significant(t =1.853,P ＞ 0.05).The positive detection rate PCT,CRP and PCT,CRP combined detection of patients in observation group were significantly higher than the control group,the difference were statistically significant(The values of T were 8.517,14.624 and 5.433,respectively,all P ＜ 0.05).The specificity 95.83 ％ (46/48),sensitivity 91.43 ％ (32/35),positive predictive value of 93.88％ (46/49) and the negative predictive value 97.06％ (33/34) of PCT and CRP combined detection were significantly higher than those of PCT and CRP used alone (P ＜ 0.05).Conclusion There is risk of pulmonary infection in patients with liver cirrhosis,combined detection of PCT and CRP in patients with liver cirrhosis might be a useful tool in the early diagnosis of pulmonary infection.