血清降钙素原测定在社区获得性肺炎患者中的临床意义

The clinical significance of serum procalcitonin determination in patients with community acquired pneumonia

目的探讨血清降钙素原（PCT）测定在社区获得性肺炎（CAP）患者中的临床意义。方法选择我院2013年10月~2014年11月收治的82例CAP患者作为观察对象,根据病情严重程度分为重症肺炎组（29例）和普通肺炎组（53例）;并选择同期健康体检者45例设为对照组,抽取清晨静脉血,采用德国Brahms半定量快速检测法进行PCT测定,观察其在CAP中的敏感性和特异性,并对CURB-65评分、CRP及WBC指标进行比较。结果 PCT在CAP诊断中的升高率为81.71%,正常率为18.29%。重症肺炎组血清PCT水平、CURB-65评分高于普通肺炎组（P〈0.05）。根据CURB-65评分将82例CAP患者分为三组,4~5分组患者PCT水平高于0~1分、2~3分组（P〈0.05）。4~5分组WBC高于0~1分组（P〈0.05）,但与2~3分组比较差异无统计学意义（P〉0.05）。三组CRP水平比较差异无统计学意义（P〉0.05）。结论 PCT水平对CAP患者的严重程度的评估及预后的预测上有一定的价值。

Objective To investigate the clinical significance of serum procalcitonin（PCT）determination in patients with community acquired pneumonia（CAP）. Methods Eighty-two patients with CAP cared at our hospital from October 2013 to November 2014 were included as the observation objects,according to the severity of the disease all the patients were divided into a severe pneumonia group（29cases）and a common pneumonia group（53cases）;and 45 healthy subjects were enrolled as the control group.The venous blood of the patients was drawn in the morning.PCT measurement was done by using German Brahms rapid semiquantitative detection method,observed the sensitivity and specificity of PCT in diagnosis of CAP,and comparison of the CURB-65 scores,CRP and WBC index was done. Results In CAP group,81.71% of 82 patients had elevated PCT levels,18.29% of them had normal PCT levels.In the severe pneumonia group,the levels of serum PCT,CURB-65 scores were higher than those of common pneumonia group（P〈0.05）.According to CURB-65 scores,82patients with CAP were divided into three groups,patients of 4~5score group had higher PCT level than 0~1score group and 2~3score group（P〈0.05）.4~5score group had higher WBC level than 0~1score group（P〈0.05）,but compared with 2~3score group,there was no statistically significant difference（P〉0.05）.Comparison of the CRP levels among the three groups showed no statistically significant differences（P〉0.05）. Conclusion PCT has certain value in assessing disease severity and predicting prognosis of patients with CAP.