C反应蛋白和前白蛋白在老年社区获得性呼吸道感染中的诊断价值

The Values of C-reactive Protein and Prealbumin in the Diagnosis of Community Aouired Respiratory Tract Infection among Elderly Patients

目的：探讨血清C—反应蛋白(CRP)和前白蛋白(PA)在老年急性社区获得性呼吸道感染诊断中的应用价值。方法：将175例住院老年患者按血象和抗菌药物治疗后的疗效分为细菌感染组和病毒感染组,另将90例体检的健康老人作对照组。比较3组间CRP和PA的血清浓度及阳性率,并分析治疗前后两者的血清浓度变化。结果：细菌感染组中,CRP和PA阳性率明显高于病毒感染组(CRP81.84%比13.04%,PA9.09%比3.56%,P＜0.01),其中CRP阳性率明显高于PA和白蛋白阳性率(81.84%比9.09%,81.84%比35.94%,P＜0.01)。CRP血清浓度明显高于病毒感染组(65.51±60.98mg/L比5.86±4.48 mg/L,P＜0.01),PA血清浓度明显低于病毒感染组(166.49±69 mg/L比201.81±53.03 mg/ L,P＜0.01),治疗后CRP血清浓度明显降低(65.51±60.98 mg/L比20.22±30.72 mg/L,P＜0.01),PA血清浓度明显增高(166.49±69 mg/L比206.84±57.32 mg/L,P＜0.01)。病毒感染组与对照组相比无显著差异。结论：CRP和PA可以用来初步鉴别细菌性或病毒性急性呼吸道感染,并对疾病的严重程度、抗菌药物疗效判断都有一定的指导价值,其中CRP更敏感。

Objective：To evaluate the values of C-reactive protein and prealbumin in the diagnosi of community aquired respiratory tract infection among elderly patients. Methods.. 175 elderly in-patients were divided into two groups：bacterial infection group and viral infection group,according to their total account of peripheral white blood cells and the effect of antibiotic. 90 healthy elder persons were as the control group. Their serum values and positive rates of CRP and PA were analyzed. Resuits：The positive rates of CRP and PA in bacterial infection group were significantly higher than in viral infection group（CRP was 81.84% vs 13.04%,PA was 9. 09% vs 3. 56%,P〈0. 01）,and the positive rates of CRP were significantly higher than that of PA and albumin（81.84% vs 9. 09% ,81.84% vs 35.94% ,P〈0. 01 ）. The serum values of CRP were significantly higher in bacterial infection group than in viral infection group（65. 51± 60. 98mg/L vs. 5.86 ± 4. 48mg/L,P〈0. 01） ,and that of PA were lower（166. 49 ± 69mg/L vs 201.81 ± 53.03mg/L,P〈0. 01 ）. The serum values of CRP were lower（65. 51 ± 60. 98mg/ L vs 20. 22±30. 72mg/L,P〈0. 01）, and PA were higher（166. 49± 69mg/L vs. 206. 84± 57. 32mg/L,P〈0. 01） after treatment. The serum values and positive rates of CRP and PA between viral infection group and control group had no difference. Conelusion：CRP and PA could be preliminarily used to disdinguish the pathogen of acute respiratory infection,and they had instructive values in the judgement of severity of diseases and effect of antibiotic.