D-二聚体、C反应蛋白、降钙素原水平与老年社区获得性肺炎严重程度及预后的关系

【摘要】目的探讨D-二聚体、C反应蛋白（CRP）及降钙素原（PCT）水平与老年社区获得性肺炎（CAP）严重程度及预后的关系。方法收集114例老年社区获得性肺炎患者的临床资料，测定患者血浆D-二聚体、CRP及PCT水平，按不同的病情严重程度标准对患者进行分组。比较不同肺炎严重指数（PSI）分级间、不同CURB-65分组间、重症肺炎组与非重症肺炎组、死亡组与生存组之间的差异。结果不同肺炎严重指数（PSI）分级间、不同CURB-65分组间血浆D-二聚体、CRP及PCT水平比较差异均有统计学意义（P〈0．01），血浆D-二聚体、CRP、PCT水平重症肺炎组显著高于非重症肺炎组（P〈0．01），死亡组高于生存组（P〈0．01）。血浆D-二聚体水平与CRP水平存在相关性（r=0．526，P〈0．01），且与预后之间有显著相关性（r：0．630，P〈0．01）。PCT与预后之间有显著相关性（r=0．766，P〈0．01）。结论血浆D-二聚体、CRP、PCT水平与老年CAP的严重程度有一定相关性，可作为判断病情的指标。D-二聚体及PCT水平可较好地预测社区获得性肺炎患者的预后。

The correlations of plasma D-dimer, CRP, Procalcitonin levels and the severity and prognosis in elderly patients with CAP

Objective To investigate the correlations of plasma D-dimer, C-reactive protein （CRP）, procalcitonin （PCT） levels and the severity and prognosis in elderly patients with community-acquired pneumonia （CAP）. Methods One hundred and fourteen elderly patients with CAP were included in this study. Their plasma D-dimer, CRP and PCT levels were measured. They were divided into different groups by different severity assessment criteria. Different pneumonia severity index （PSI） groups, different CURB-65 groups, severe and non-severe pneumonia groups, and fatal and non-fatal pneumonia groups were decided and compared. Results The D-dimer, CRP and PCT levels were differ- ent significantly （P 〈 0.01） among different PSI groups and different CURB-65 groups. The D-dimer, CRP and PCT levels were higher in severe pneumonia group than in non-severe pneumonia group （P 〈 0.01） , and higher in fatal group than in non-fatal group （P 〈 0.01）. D-dimer had correlation with CRP （r = 0.526, P 〈 0.01） and was correlated with prognosis remarkably （r = 0.630, P 〈 0.01）. PCT was correlated with prognosis remarkably （r = 0.766 P 〈 0.01）. Con- clusion Plasma D-dimer, CRP and PCT levels correlated with severitvy and it can be useful for assessment of the severity of CAP in elderly patients. D-dimer and PCT levels can predict prognosis better in elderly patients with CAP.