降钙素原和C反应蛋白对老年人下呼吸道感染病情严重程度及预后评估的价值

目的探讨降钙素原(PCT)和C反应蛋白(CRP)对老年人下呼吸道感染病情严重程度及预后评估的价值。方法研究对象为下呼吸道感染患者95例(病例组,包括轻度31例,中度34例,重度30例)及30例健康查体者(对照组),测定血清PCT和CRP水平,观察呼吸衰竭发生率和住院时间。结果病例组血清PCT和CRP水平较对照组显著升高,差异均有统计学意义(P<0.01);老年下呼吸道感染患者中度组较轻度组,重度组较中度组,重度组较轻度组血清PCT和CRP水平均明显升高,差异有统计学意义(P<0.05)。血清PCT和CRP水平呈正相关;血清PCT和CRP水平与病情严重程度评分呈正相关(P<0.01)。发生呼吸衰竭患者血清PCT和CRP水平显著高于未发生呼吸衰竭患者,差异均有统计学意义(P<0.01)。以血清PCT>1.5μg/L为临界值,老年下呼吸道感染患者中有85例血清PCT增高,住院时间(13.39±13.82)d明显高于血清PCT不增高者的(9.06±8.67)d,差异有统计学意义(t=2.45,P<0.01);以血清CRP>10 mg/L为临界值,老年下呼吸道感染患者中有79例血清CRP增高,住院时间为(13.87±12.06)d,明显高于CRP不增高者的(9.15±8.24)d,差异有统计学意义(t=2.86,P<0.01)。结论联合检测PCT和CRP可反映老年下呼吸道感染患者的病情严重程度,对其预后评估有一定价值,为正确地抗感染治疗提供理论依据。

Value of Procalcitonin and C-Reactive Protein in Assessing the Severity and Prognosis of Elderly Patients with Lower Respiratory Tract Infection

Objective To evaluate the value of procalcitonin(PCT) and C-reactive protein(CRP) in assessing the severity and prognosis of elderly patients with lower respiratory tract infection.Methods 95 elderly patients with lower respiratory tract infection(case group) and 30 healthy people(control group) were involved into the study.PCT and CRP were detected,and the incidence of respiratory failure and hospital stays were observed.Results The levels of serum PCT and CRP in case group were significantly higher than those in control group(P<0.01).The levels of serum PCT and CRP were significantly increased when comparing moderate group with mild group,severe group with moderate group and severe group with mild group(P<0.05).Serum PCT was positively correlated with CRP and serum PCT and CRP were positively correlated with the severity of the disease.The levels of serum PCT and CRP in patients with respiratory failure were significantly higher than those in patients without respiratory failure(P<0.01).When taking PCT>1.5 μg/L as critical value,85 elderly patients with lower respiratory tract infection had increased serum PCT,and their hospital stays(13.39±13.82)d were significantly longer than those without increased serum PCT(9.06±8.67) d(t=2.45,P<0.01).When taking CRP>10 mg/L as critical value,79 elderly patients with lower respiratory tract infection had increased serum CRP,and their hospital stays(13.87±12.06)d were significantly longer than those without increased serum CRP(9.15±8.24)d(t=2.86,P<0.01).Conclusion Combined detection of serum PCT and CRP in elderly patients with lower respiratory tract infection can reflect the severity of the disease and is valuable in assessing prognosis,providing theoretical evidence for correct use of antibiotics.