血清降钙素原在重症肺炎中的临床诊断意义

Role of serum procalcitonin in clinical diagnosis of severe pneumonia

目的探讨血清降钙素原在重症肺炎中的临床诊断意义。方法对2009年11月-2011年9月我院46例重症肺炎患者、40例轻症肺炎患者和50例健康体检者的血清降钙素原(procalcitonin,PCT)和其他项目进行检验分析。结果 PCT重症肺炎组(17.34±12.32)ng/ml,轻症肺炎组(9.34±3.34)ng/ml、对照组(0.23±0.06)ng/ml,差异有统计学意义(P<0.05);细菌性肺炎组PCT为(19.34±8.85)ng/ml,病毒性肺炎组(6.43±0.32)ng/ml、支原体肺炎组(5.34±0.16)ng/ml、对照组,差异有统计学意义(P<0.01),而各组其他指标(C反应蛋白、白细胞计数、中性粒细胞百分比)虽高于对照组,但敏感性和特异性均不如PCT,而且PCT不受非感染因素的影响,能反映肺炎患者的严重程度,成为区分细菌感染、病毒感染及支原体感染的有效指标。结论血清PCT对重症肺炎诊断、鉴别诊断及病情严重程度评估有指导意义。

Objective To study the role of serum procalcitonin（PCT） in clinical diagnosis of severe pneumonia.Methods Serum PCT level,and C-reactive protein level,number of white blood cells,percentage of neutrophils in 46 severe pneumonia patients,40 mild pneumonia patients and 50 controls admitted to our hospital from November 2009 to September 2011 were analyzed.Results The serum PCT level was 17.34±12.32 ng/ml in severe pneumonia patients,which was significantly higher than that in mild pneumonia patients（9.34±3.34） ng/ml and controls（0.23±0.06） ng/ml（P0.05）.The serum PCT level was 19.34±8.85 ng/ml in bacterial pneumonia patients,which was significantly higher than that in viral pneumonia patients（6.43±0.32） ng/ml,mycoplasma pneumonia patients（5.34±0.16） ng/ml and controls（P0.01）.Although the C-reaction protein level,number of white blood cells,percentage of neutrophils were higher in pneumonia patients,their sensitivity and specificity were lower than those of PCT.The serum PCT level was not influenced by non-infectious factors and could reflect the severity of pneumonia,and thus could be used as an effective indicator to distinguish bacterial pneumonia from viral pneumonia or mycoplasma pneumonia.Conclusion Serum PCT plays an important role in clinical diagnosis of severe pneumonia and in assessment of its severity.