血清降钙素原在老年细菌性肺炎诊断及严重程度评估中的作用

目的 探究血清降钙素原(procalitonin,PCT)检测在老年细菌性肺炎诊断及严重程度评估中的价值。 方法 回顾性分析义乌市中心医院呼吸科2015年1月-2016年6月间住院的老年肺炎患者314例,包括细菌性肺炎患者121例、病毒性肺炎患者97例和支原体肺炎患者96例,另有100例本院健康体检者作对照。将121例细菌性肺炎患者按病情轻重程度分组,统计各组血清PCT和C反应蛋白(C-reactionprotein,CRP)检测结果,采用SPSS 17.0统计软件对数据进行处理。 结果 血清PCT和CRP水平细菌性肺炎组与病毒性肺炎组、支原体肺炎组及健康对照组比较差异均有统计学意义(P<0.05);细菌性肺炎组患者病情越重血清PCT和CRP水平也越高。以0.5μg/L和10 mg/L为血清PCT和CRP阳性阈值,血清PCT和CRP诊断细菌性肺炎的灵敏度分别为90.9%和86.8%,两者灵敏度差异无统计学意义(P>0.05);特异度分别为90.4%和77.5%,血清PCT诊断细菌性肺炎的特异度明显高于血清CRP (P<0.01)。 结论 血清PCT水平对老年细菌性肺炎的病原学诊断有很高的价值,并可作为老年细菌性肺炎患者严重程度的一项评估指标。血清PCT检测在诊断老年细菌性肺炎的特异度上明显高于血清CRP。 

Roles of serum procaleitonin in the diagnosis and severity evaluation of pnemnonia in elderly patients

Objective To evaluate the usefulness of the serum procalcitonin (PCT) level as a predictor of diagnosis in elderly patients with pneumonia and to discuss the value of the serum PCT in the severity assessment of bacterial pneumonia. Methods A total of 314 pneumonia patients were respectively reviewed and assigned into bacterial pneumonia group (121 cases), viral pneumonia group (97 cases) and mycoplasma pneumonia group (96 cases) according to the diagnostic criteria for pathogens causing pulmonary infections treated from January, 2015 to June, 2016 in our hospital, and100 healthy elderly healthy people without infection at the same period were selected as the control group. The 121 bacterial pneumonia patients were grouped according to the severity of illness. All patient groups and control group were respectively detection PCT and CRP in serum. PCT and CRP contents in patients of each group were summarized and data were processed by statistical software SPSS 17.0. Results The levels of PCT and CRP in bacterial pneumonia group were significantly higher than viral pneumonia group, mycoplasma pneumonia group and control group (P<0.05); the level of PCT and CRP increased along with the severity of bacterial pneumonia. The threshold of PCT and CRP were 0.5μg/L and 10 mg/L, respectively. The sensitivity of the serum PCT and CRP were 90.9% and 86.8%, respectively, the sensitivity is no statistical different (P>0.05); the specificity of the serum PCT and CRP were 90.4% and 77.5%, respectively, the specific of serum PCT is obviously higher than that CRP (P<0.01). Conclusion PCT may have a role to predict the etiological diagnosis in patients and the severity in the bacterial pneumonia. The specific of serum PCT in the diagnosis of bacterial pneumonia was obviously higher than that of serum CRP.