降钙素原在细菌性肺炎及肺结核中的鉴别研究

Value research of procalcitonin in the identification between bacterial pneumonia and pulmonary tuberculosis

目的通过测定细菌性肺炎及肺结核患者血清降钙素原水平进一步探讨降钙素原对这两种疾病的鉴别诊断价值。方法收集细菌性肺炎患者(20例)及肺结核患者(21例)血清标本,两组患者病情严重程度达到系统性炎症反应综合征(SIRS)水平,采用免疫荧光法分别检测两组患者血清降钙素原水平,并进行比较,绘制ROC曲线,根据曲线下面积评价降钙素原对上述两种疾病的鉴别诊断价值。结果细菌性肺炎患者血清降钙素原水平明显高于肺结核患者(P<0.05),绘制ROC曲线后,曲线下面积(AUC)为0.923,95%可信区间为(0.844,1.000),在临界值为0.20 ng/ml时,其灵敏度为85%,特异度为86%。结论降钙素原在临界值为0.20 ng/ml时,对达到SIRS水平的细菌性肺炎及肺结核患者具有良好的鉴别诊断价值。

Objective To explore the differential value of procalcitonin between bacterial pneumonia and pulmonary tuberculosis.Methods The serum procalcitonin of patients with bacterial pneumonia（20 cases） and pulmonary tuberculosis（21 cases） was detected by immunofluorescence and then compared.All patients were suffering from systemic inflammatory response syndrome（SIRS）.ROC curves were described and the differential value of procalcitonin was evaluated according to AUC.Results The level of serum procalcitonin was significantly higher in patients with bacterial pneumonia than in patients with pulmonary tuberculosis（P0.05）.The AUC of ROC curve was 0.923,95%CI（0.844,1.000）.At the cut-off value of 0.20 ng/ml,the sensitivity was 85%,and the specificity was 86%.Conclusion When the level of procalcitonin reaches the cut-off value of 0.20 ng/ml,procalcitonin can be used as a valuable clinical inflammatory marker to differentiate bacterial pneumonia and pulmonary tuberculosis with SIRS.