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

The clinical value of dynamic monitoring of serum C-reactive Protein and Procalcitonin in elderly patients with severe pneumonia

目的 探讨动态监测C反应蛋白（ CRP）和降钙素原（ PCT） 水平对判断老年重症肺炎患者病情严重程度及预后的意义.方法 42例老年重症肺炎患者入院后第1、3、5天分别进行CRP、PCT和WBC检测,同时根据预后将42例老年重症肺炎患者分为分为死亡组和存活组进行分析比较.结果 42例患者死亡12例,存活30例.死亡组第3、第5天CRP[（121±25）、（140±34） mg/L]明显高于存活组CRP[（88±35）、（53±24）mg/L],P＜0.05.死亡组第3天、第5天PCT[（28.4± 5.5）、（39.6± 6.2）μg/L]水平显著高于存活组PCT[（8.4±3.8）、（5.3±4.2）μg/L],P＜0.05.在存活组中随着病情的好转,PCT及CRP明显下降,而WBC下降不明显,在死亡组中随着病情的恶化,PCT及CRP明显升高,而WBC升高不明显.结论 动态监测血清PCT和CRP水平变化趋势有助于老年重症肺炎预后的判断.

Objective To evaluate dynamic monitoring of serum C-reactive protein （CRP） and procalcitonin （PCT） levels in severity and prognosis assessment of elderly patients with severe pneumonia. Methods A total of 42 cases of elderly patients with severe pneumonia were enrolled in the study, 12 patients died （fatal group） and 30 survived （survival group） during the hos- pitalization. The WBC contents, serum CRP and PCT levels were determined at the dl, d3 and d5 of admission and compared between two groups. Results The CRP levels in fatal group on d3 and d5 were significantly higher than those of survival group （ 121± 25 vs 88± 35 mg/L and 140 ± 34 vs 53 ± 24 mg/L,respectively, P〈0.05）. The PCT levels in fatal group on d3 and d5 were significantly higher than those in survival group（28.4 ± 5.5 vs 8.4 ± 3.8μg/L and 39.6± 6.2 vs 5.3 ± 4.2 μg/L, respectively, P〈0.05）. The CRP and PCT levels in the survival group decreased significantly with improvement of the disease, while the WBC was not declined significantly. The CRP and PCT levels in the fatal group increased significantly with deterioration of disease, while the WBC was not increased significantly. Conclusion Dynamic monitoring of serum PCT and CRP levels is valuable in prognosis assessment for elderly patients with severe pneumonia.