社区获得性肺炎检测血清降钙素原的临床价值分析

目的探讨血清降钙素原（procalcitonin，PCT）定量检测对社区获得性肺炎（community acquired pneumonia，CAP）患者的临床诊断价值。方法采用电化学发光法，对50例CAP患者和30例健康体检者进行血清PCT定量检测．免疫胶乳比浊法对其CRP进行检测并采集静脉血进行白细胞计数，分别计算其诊断CAP的灵敏度及特异性。根据CAP患者的转归，将其分为死亡组与好转组，比较患者人院第1、4、7d血清PCT浓度。结果与对照组比较，患者组血清PCT、CRP及全血WBC水平显著增高，差异均有统计学意义（P〈0．05）。在诊断CAP的灵敏度上，PCT（0．93）与CRP（0．87）相比，P〉0．05，差异无统计学意义；PCT（0．93）与WBC（0．67）相比，P〈0．05，差异有统计学意义。在诊断CAP的特异性上，PCT（0．96）与CRP（0．88）和WBC（0．92）相比，差异均有统计学意义（P〈0．05）。死亡组第1、4、7d血清PCT水平与好转组比较，其浓度明显升高（P〈0．05）。结论血清PCT定量检测是诊断CAP灵敏度、特异性均较好的指标，且血清PCT浓度高低对患者的预后评估有重要的参考价值。

The clinical value of serum procalcitonin quantitative detection in patients with community acquired pneumonia

Objective To explore the clinical value of serum procalcitonin in patients with community acquired pneumonia. Methods The serum PCT and CRP level of 50 patients with CAP infection and 30 healthy controls were detected by using electrochemiluminescence immunoassay and turbidity method,and venous blood was collected for white blood cell count. Then calculated the sensitivity and specificity of the three indicators. Based on the outcome of the 50 patients with CAP,they were divided into death group and improvement group, and compared the serum level on the 1,4,7 hospitalized days in the two groups. Results The serum PCT and CRP level and whole blood WBC count in patient group were obviously higher than the control group,and the comparison had significant difference （P〈0.05）. As for the diagnostic sensitivity of CAP,the comparison between PCT（0.93） and CRP（0.87） had no significant difference（P〉0.05）;the comparison between PCT（0.93） and WBC（0.67） had significant difference （P〈0.05）. As for the specificity,the comparison between PCT（0.96） and CRP（0.88） as well as WBC （0.92） both had significant difference （P〈0.05）. The serum PCT level on the 1,4,7 hospitalized days in the death group was obviously higher than the improvement group. Conclusion Serum PCT quantitative detection is a better diagnostic indicator both in the sensitivity and specificity,and the serum PCT level has important reference meaning for evaluating the prognosis of the CAP patients.