血清降钙素原在社区获得性肺炎诊断与病情评估中的价值

目的探讨血清降钙素原(PCT)在社区获得性肺炎(CAP)诊断与病情评估中的临床价值。方法选取社区获得性肺炎患者120例,并根据肺炎严重指数(PSI)分为高危、中危和低危组,另选取20名健康者为对照组,并检测两组研究对象的血清C-反应蛋白(CRP)水平,分析PCT对诊断CAP的敏感性、特异性及与病情严重程度的关系。结果 CAP肺炎患者血清PCT和CRP水平均明显高于正常对照组(P0.05),不同程度肺炎患者血清中PCT差异有统计学意义(P0.05),且随着病情严重程度的增加而增加。当以1.5 ng/ml为临界点时,PCT诊断CAP的敏感性和特异性分别为93.7%和84.6%,ROC曲线下面积为0.912(95%可信区间:0.814~0.962),ROC曲线下面积明显大于CRP(0.826,95%可信区间:0.7 21~0.895)。结论血清降钙素原诊断社区获得性肺炎具有较好的特异性和灵敏性,且可反应病情严重程度,对指导临床诊断、治疗和评估病情具有重要意义。

Diagnosis significance and usefulness of plasma procalcitonin in community-acquired pneumonia

Objective To investigate the diagnosis significance and usefulness of plasma procalcitonin（PCT） in community- acquired pneumonia（CAP） and estimate of severity. Methods A total of 120 patients with CAP were enrolled in this study, and 20 healthy individuals were served as the controls.CAP patients were divided into three CAP groups according to different severity assessment criteria. The variance of PCT and C-reactive protein （CRP）levels were detected and analyzed. Results The mean procalcitonin and CRP levels were significantly increased in CAP patients than in healthy controls （P〈0.05）, and there were statistically significant differences among the difference degree of severity of the disease （P〈0.05）. When the best cut-off value of PCT was defined as 1.5 ng/ml, the sensitivity and specificity were 93.7 % and 86.4%, respectively. The area under receiver operating characteristic （ROC） curve of PCT was 0.912 （95% confidence interval： 0.814-0.962）, which was higher than those of CRP[0.826（95% CI：0.721-0.895）]. Conclusions Plasma PCT level is correlated with the severity of CAP.Dynamic measurement of PCT may be helpful to evaluate condition of CAP patients.