血清降钙素原动态监测在肺炎严重程度评估和预后判断中的应用价值被引量：2

Application value of changes of blood clearance of procalcitonin dynamic in hospitalized patients with community-acquired pneumonia in the assessment of pneumonia severity and prognosis

在线阅读下载PDF

导出

摘要目的探讨社区获得性肺炎(CAP)住院患者血清降钙素原(PCT)动态监测在评估肺炎严重程度和预后判断中的应用价值。方法对某社区的100例CAP患者的临床资料进行回顾性分析,并于入院次日清晨抽取外周静脉血,采用酶联免疫吸附试验(ELISA)对患者血清中的PCT水平进行测定、分析,将其按照严重程度分为三组,即普通CAP组(49例)、重症CAP组(39例)及死亡CAP组(12例),比较三组基线资料、血PCT浓度及简化肺炎预后评分系统(PORT)分层与PCT水平的相关性。结果 (1)三组患者中,平均年龄、简化PORT评分、平均住院时间、静脉抗菌药物使用时间、住院费用等方面的差异均具有统计学意义(P<0.05);(2)三组血清PCT水平从低到高依次为:普通CAP组、重症CAP组、死亡CAP组,且两两比较差异具有统计学意义(P<0.05);(3)血清PCT水平与PORT分层的相关系数为0.929(P<0.05)。结论 CAP住院患者血清PCT动态监测在评估肺炎严重程度和预后判断中具有较大的价值,能够提高患者的临床诊断准确度,有助于及时地采取有效的治疗措施。 Objective To explore the application value of dynamic changes of blood clearance of procalcitonin （PCT） in hospitalized patients with community-acquired pneumonia（CAP） in the assessment of pneumonia severity and prognosis. Methods 100 cases of community patients with CAP in our hospital were retrospectively analyzed, and peripheral venous blood was extracted on the next morning, and serum PCT levels were measured by ELISA. The patients were randomly divided into three groups according to severity namely ordinary CAP group（n= 49）, severe CAP group （n ： 39） and dead group （n ： 12 ）. Baseline data, serum PCT concentrations, and Pneumonia Prognostic Scoring System（PORT） layered PCT levels were compared. Results （1） There were statistically significant differ- ences of the mean age, simplifying PORT, the average number of clays of hospitalization, intravenous antibiotics, hos- pitalization costs and other aspects among the three groups of patients（P^0.05）. （2） Serum PCT value~ ordinary CAP group~ severe CAP group~ dead group,and there was a statistical difference between any of the three groups （P〈0.05）. （3） Correlation coefficient of serum PCT levels and PORT layer was 0. 929（P〈0.05）. Conclusion The dynamic changes of blood clearance of procalcitonin in hospitalized patients with community-acquired pneumonia has large value in the assessment of pneumonia severity and prognosis,and it could improve the patientrs clinical diagnos- tic accuracy,and offer timely and effective treatment measures.

作者赵和平于燕

机构地区西安交通大学医学院附属红会医院

出处《检验医学与临床》 CAS 2013年第21期2799-2800,2802,共3页 Laboratory Medicine and Clinic

关键词社区获得性肺炎血清降钙素原酶联免疫吸附试验 community-acquired pneumonia serum procalcitonin ELISA

分类号 R563.1 [医药卫生—呼吸系统]

引文网络
相关文献

参考文献10

1吴祖凤,汪铮,李秀,王同,丁震,张春美,陈若静.社区获得性肺炎住院患者血清降钙素原与肺炎严重程度和预后的关系[J].安徽医药,2011,15(10):1278-1280. 被引量：22
2朱红俊,徐俊龙,张剑.动态监测血清C反应蛋白、降钙素原在老年重症肺炎患者中的意义[J].浙江医学,2012,34(12):1015-1016. 被引量：22
3Schuetz P, Christ-Crain M, Thomann R, et al. Effect of procalcitonin-based guidelines vs standard guidelines on antibiotic use in lower respiratory tract infections: the ProHOSP randomized controlled trial[J]. JAMA, 2009, 302(10) .. 1059-1066.
4Chalmers JD, Singanayagam A, Akram AR, et al. Severity assessment tools for predicting mortality in hospitalised patients with community acquired pneumonia. Systematic review and meta-analysis[J]. Thorax, 2010,65 (10) : 878- 883.
5瞿介明,Hanssa Summah.血清生物标志物鉴别肺部感染性及非感染性疾病的价值评估[J].中国呼吸与危重监护杂志,2009,8(6):517-518. 被引量：6
6Bafadhel M,Clark TW. Procalcitonin and C reactive pro- tein in hospitalized adult patients with community ac- quired pneumonia, exacerbation of asthma and chronic ob- structive pulmonary disease[J] Chest, 2011, 136 (6) : 1410-1418.
7Chen JH,Chang SS, Liu JJ, et al. Comparison of clinical characteristics and performance of pneumonia severity score and CURB-f5 among younger adults, elderly and very old subjects[J]. Thorax,2010,65(11) :971-977.
8Kopterides P,Siempos II,Tsangaris I,et a[. Proealcitonin- guided algorithms of antibiotic therapy in the intensivecare unit: a systematic review and meat-analysis of ran- domized controlled trials [J]. Crit Care Med, 2010, 38 (11) :2229-2241.
9Liew YX, Chlebicki MP, Lee W, et al. Use of procalcitonin (PCT) to guide discontinuation of antibiotic use in an un- specified sepsis is an antimicrobial stewardship program (ASP) [J]. Eur J Clin Microbiol Infect Dis, 2011,30 (7) : 853-855.
10唐伦先,叶海燕,张常晶,马少林.降钙素原的动态变化对老年重症社区获得性肺炎预后的评估价值[J].中国急救医学,2011,31(7):587-590. 被引量：37

二级参考文献54

1邱菁华,刘励军,Philippe Sauder.血清降钙素原和感染可能性评分对危重症患者感染预测的比较研究[J].中国急救医学,2005,25(6):391-394. 被引量：18
2社区获得性肺炎诊断和治疗指南[J].中华结核和呼吸杂志,2006,29(10):651-655. 被引量：3072
3Flanders SA, Stein J, Shochat G,et al. Performance of a bedside C-reactive protein test in the diagnosis of community-acquired pneumonia in adults with acute cough. Am J Med,2004,116 :529- 535.
4Almirall J, Bolibar I, Toran P, et al. Contribution of C-reactive protein to the diagnosis and assessment of severity of communilyacquired pneumonia. Chest,2004,125 : 1192-1195.
5Smith RP, Lipworth BJ. C-reactive protein in simple communityacquired pneumonia. Chest, 1995,107 : 1028-1031.
6Offidani M, Corvatta L, Malerba L, et al. Diagnostic value of C- reactive protein in discriminating fungal from nonfungal pulmonary infiltrates in patients with hematologic malignancies. Support Care Cancer,2006,14:874-877.
7P6voa P, Coetho L, Ahneida E, et al. C-reactive protein as, a marker of infection in critically ill patients. Clin Microbiol Infect, 2005,11 : 101-108.
8Chan YL,Tseng CP, Tsay PK, et al. Procalcitonin as a marker of bacterial infection in the emergency department: an observational study. Crit Care,2004,8 : R12-R20.
9Pelosi P, Barassi A, Severgnini P,et al. Prognostic role of clinical and laboratory criteria to identify early ventilator-associated pneumonia in brain injury. Chest,2008,134:101-108.
10Gendrel D, Raymon J, Moulin F, et al. Procalcitonin in community-acquired pneumonia: comparison with interleukin-6, C- reactive protein, and interferon-alpha for diagnosis of bacterial vs. viral infections in children. Abstr Intersci Conf Antimicrob Agents Chemother Intersci Conf Antimicrob Agents Chemother, 1999,39 : 237.