降钙素原与C反应蛋白在老年社区获得性肺炎患者预后评估中的应用价值

Value of procalcitonin and C reactive protein to evaluate prognosis of elderly patients with community ac- quired pneumonia

目的研究降钙素原（PCT）与c反应蛋白（CRP）在老年社区获得性肺炎患者预后评估中的作用。方法124例老年社区获得性肺炎患者，入院后给予PCT、CRP等检查，并给予肺炎严重指数（PSI）评分。根据是否为重症肺炎，将社区获得性肺炎分为重症组（58例）和非重症组（66例），比较2组患者PCT、CRP和PSI的区别，分析PCT、CRP与PSI的相关性。结果①重症组的PCT、CRP和PSI评分均高于非重症组，组间差异有统计学意义[PCT：（11±4）μg／L比（9±4）μg/L，CRP：（28±13）mg／L比（23±10）mg／L，PSI：（86±27）分比（73-4-27）分，均P〈0．05]；②死亡患者（20例）的PCT、CRP和PSI评分分别为（12±4）μg/L、（31±12）mg／L、（102±32）分，存活患者（104例）的PCT、CRP和PSI评分分别为（9±4）μg／L、（24±11）mg／L、（75±24）分，死亡和存活患者间各项指标的差异均有统计学意义（均P〈0．05）；③PCT、CRP与PSI评分呈正相关（r=0．64，r=0．71，均P〈0．05）。结论PCT和CRP对老年社区获得性肺炎患者的预后和病情有评估作用，高水平的PCT和CRP提示预后不佳。

Objective To study efficiency of C reactive protein （CRP） and procalcitonin（PCT） in elderly patients with community acquired pneumonia（CAP）. Methods Totally 124 cases of elderly CAP patients were se- lected in our hospital, PCT, CRP and pneumonia severity index （PSI） score were examed after admission, the difference of CRP, PCT and PSI score were compared between the death group and the survival group, those were compared between the severe pneumonia and no severe pneumonia group too; the content of CRP, PCT and PSI score correlation analysis were carried out. Results The PCT, CRP levels and PSI scores of death group were grea- ter than those in survival group [ PCT： （ 11 ± 4） μg/L vs （ 9 ± 4） μg/L, CRP： （ 28 ± 13 ） μg/L vs （ 23± 10） mg/L, PSI ： （ 86 ± 27 ） scores vs （73± 27 ） scores, P 〈 0.05 ] ; the level of PCT, CRP nand PSI scores of severe pneumo- nia patients were greater than in no severe pneumonia patients. Correlation analysis showed that PCT, CRP levels had positive correlation with PSI score （ r = 0.64, 0.71, P 〈 0.05 ）. Conclusion The PCT and CRP levels have certain prognostic evaluation function for elderly patients with CAP ; high levels of PCT and CRP suggest a poor prognosis.