老年革兰阴性菌肺炎患者血清降钙素原、内毒素及C反应蛋白水平变化及临床意义

Expression changes and clinical value of serum procalcitonin,endotoxin and CRP in elderly Gram-negative bacteria pneumonia patients

目的明确降钙素原(PCT)、内毒素(LPS)及C反应蛋白(CRP)检测在老年革兰阴性菌肺炎患者诊治中的应用价值。方法选取革兰阴性菌肺炎、非典型病原体(或病毒感染)两组老年患者各45例,观察两组患者之间以及革兰阴性菌肺炎组内治疗前后、症状轻重患者间,PCT、LPS及CRP水平的差异。结果革兰阴性菌肺炎组PCT及LPS水平明显高于非典型病原体(或病毒感染)组,差异有统计学意义(P<0.01);CRP在两组间差异无统计学意义(P>0.05);革兰阴性菌肺炎组内,重症患者PCT及CRP水平显著高于非重症患者,差异有统计学意义(P<0.01);LPS在两组间差异无统计学意义(P>0.05);革兰阴性菌肺炎组内,患者治疗前后PCT、CRP水平差异有统计学意义(P<0.01);LPS水平在两组间差异无统计学意义(P>0.05)。结论联合检测血清PCT、LPS以及CRP水平,对于老年革兰阴性菌肺炎患者的诊断,以及预后的评估,具有较高的应用价值。

Objective To investigate the expression changes and clinical value of serum procalcitonin（PCT）,lipopolysaccharide（LPS） and C reactive protein（CRP） in elderly Gram-negative bacteria pneumonia patients.Methods Serum PCT,LPS and CRP were measured in 45 elderly Gram-negative bacteria pneumonia patients and 45 non-bacteria pneumonia patients.The elderly Gram-negative bacteria pneumonia patients were subdivided into before and after treatment groups,severe and non-severe infection groups.Results Serum PCT and LPS in Gram-negative bacteria pneumonia patients were significantly higher than those in non-bacteria patients（P0.01）,and there was no significant difference of CRP between two groups（P0.05）.Serum PCT and CRP in severe infection patients were significantly higher than those in non-severe infection patients（P0.01）,and there was no significant difference of LPS between two groups（P0.05）.Serum PCT and CRP significantly decreased in patients after treatment（P0.01）,and there was no significant difference of LPS between two groups（P0.05）.Conclusion Measurements of serum PCT,LPS and CRP were valuable for clinical diagnosis and evaluation of prognosis of elderly Gram-negative bacteria pneumonia patients.