血清降钙素原在肺炎诊断及严重程度判断中的研究被引量：28

Roles of serum procalcitonin in the diagnosis and severity evaluation of pneumonia in adult patients

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摘要目的:评价血清降钙素原(PCT)对肺炎诊断及严重程度评估中的应用价值。方法:本研究为前瞻性,收集肺炎患者51例,检测患者的血清PCT、C-反应蛋白(CRP)、内毒素(LPS)、白细胞(WBC)计数及白细胞介素-6(IL-6)。结果:1.痰细菌培养阳性肺炎组PCT水平较支原体肺炎或衣原体肺炎组高,差异有统计学意义(P<0.01),较病原学检测阴性肺炎组高,差异有统计学意义(P<0.01),病原学检测阴性肺炎组PCT水平较支原体肺炎或衣原体肺炎组高,差异无统计学意义(P>0.05)。2.有并发症组的PCT水平较无并发症组高,差异有统计学意义(P<0.05)。PCT水平在中高危组较低危组高,差异有统计学意义(P<0.05);PCT阳性率在中高危组较低危组高,差异有统计学意义(P<0.05)结论:血清PCT水平对肺炎的病原学诊断有一定的预测价值,而CRP、内毒素、WBC计数及IL-6组间,差异无统计学意义;血清PCT作为肺炎患者严重程度的一项评价指标可能具有一定意义。 Objective：To evaluate the usefulness of serum procalcitonin（PCT） level as a predictor of diagnosis in adult patients with pneumonia and to discuss the value of PCT in the severity assessment of pneumonia.Methods： It is a prospective study,in the 51 patients with pneumonia were enrolled in this trial.Patients’ data were collected,including basic information,associated diseases,imaging examination,microbiology,blood gases analysis,and CURB-65 Score（respiratory rate,blood pressure,renal function,consciousness,age）.Meanwhile,the values of PCT,CRP and WBC,IL-6,endotoxin were detected within the first 24h of admission.Results： 1.The level of PCT of the group with positive sputum culture was higher than that of mycoplasma or chlamydia pneumonia group,the varies had statistics significant between the two groups（P=0.006）,it is also higher than that of the patients without etiology（P=0.004）.However,the levels of WBC、CRP、IL-6 and endotoxin among the groups had no significant differences（P〉0.05）.2.Patients with complications had a higher PCT level than those who did not.Pneumonia Severity Classification（CURB-65 Score） is an objective standard for estimating the severity of condition of pneumonia.According to this score,with 2 scores as critical value,patients was divided into two groups,using 0.1ug/L as critical values,the values of PCT were divided into two groups,significant difference was observed between mortality low group and mortality intermediate or high group（P=0.026）.Conclusion： PCT may have a role to predict the etiological diagnosis in patients with pneumonia and have an advantage over CRP、endotoxin、 WBC and IL-6.The study also suggests that PCT may have a role to predict the severity in the patients with pneumonia.

作者王珊刘双

机构地区首都医科大学附属北京市安贞医院北京市心肺血管疾病研究所感染科

出处《心肺血管病杂志》 CAS 2012年第3期273-277,共5页 Journal of Cardiovascular and Pulmonary Diseases

关键词肺炎降钙素原 CURB-65 诊断严重程度 Procalcitonin； Pneumonia； CURB-65 score； Diagnosis； Severity

分类号 R563.1 [医药卫生—呼吸系统]

作者简介通信作者：刘双，E-mail：liushuang862002@163．com

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