C反应蛋白对社区获得性肺炎的诊断价值

Diagnosis Value of C-reactive Protein in Community Acquired Pneumonia

目的探讨C反应蛋白(CRP)对社区获得性肺炎(CAP)的诊断价值。方法对笔者所在医院发热门诊2011年2月—2012年1月接诊的患者进行随机抽样,对抽样获得的611例患者进行回顾性分析。CRP采用QuikRead CRP快速分析仪检测。结果 611例患者中CRP增高394例(占64.5%),其中肺炎患者占16.50%(65/394),而在CRP正常的217例患者中,肺炎占4.15%(9/217),前者明显高于后者(P<0.05)。当CRP值>30 mg·L-1时,约有1/5的患者诊断为肺炎,CRP值>50 mg·L-1时,约有1/4的患者诊断为肺炎。CRP值增高对肺炎诊断的敏感性为87.84%,阳性预测值是16.50%,阴性预测值是95.85%。结论在发热门诊,CRP水平与CAP的诊断有一定的相关性,而且阴性预测值较高。

OBJECTIVE To evaluate the diagnosis value of C-reactive protein（CRP） in patients with community acquired pneumonia（CAP）. METHODS A retrospective study was performed on 611 randomly selected patients in fever clinic of Xuanwu Hospital during one year（2011-02-01-2012-01-31）. All patients were detected by the QuikRead of CRP. RESULTS In 611 patients, CRP was elevated（〉10 mg·L^-1） in 394 cases （accounting for 64.5%） in which patients with pneumonia accounted for 16.50%, while 217 patients with normal CRP level（≤10 mg.L^-1） had low proportion of CAP patients （accounting for 4.15%）. There was significant difference（P〈0.05）. When CRP levels 〉30 mg.L-1, there were about 1/5 patients diagnosed with CAP, and CRP levels 〉50 mg·L^-1, there were about 1/4 patients diagnosed with CAP. The sensitivity of CRP on the diagnosis of pneumonia was 87.84%. Total positive predictive, negative predictive value of CRP rapid test was 16.50% and 95.85%, respectively. CONCLUSION In fever clinic, the levels of CRP show a significant correction with the diagnosis of CAP, and negative predictive value of CRP testing is higher.