血清铁蛋白对军团菌肺炎诊断分析

Value of serum ferritin in diagnosis of Legionella pneumonia

目的通过比较军团菌肺炎及其他类型肺炎患者血清铁蛋白(serum ferritin,SF)水平和治疗前后变化,研究SF在军团菌肺炎诊断中的意义,为军团菌肺炎的早期治疗提供依据。方法共收集2011年3月-2013年3月肺部感染患者121例临床资料,将25例确诊军团菌肺炎患者为军团菌肺炎组、84例细菌性肺炎患者为其他细菌肺炎组、7例支原体肺炎患者为支原体肺炎组、5例病毒性肺炎患者为病毒性肺炎组,用化学发光法检测各组患者治疗前后SF水平,同时统计各组患者生化指标并进行比较,采用SPSS 12.0软件进行统计分析。结果军团菌肺炎组治疗前SF水平为(1589.3±254.9)ng/ml,其他细菌肺炎组(179.1±10.3)ng/ml和病毒性肺炎组(139.8±15.9)ng/ml的SF水平正常,支原体肺炎组SF水平(256.5±32.1)ng/ml有部分患者呈轻度升高,军团菌肺炎组经治疗后SF水平(161.6±28.6)ng/ml显著下降,与其他组比较差异有统计学意义(P<0.01);其他生化指标血沉、C-反应蛋白、血钠、血钾、谷丙转氨酶、二氧化碳结合力均有不同程度异常,但不具特异性。结论 SF显著增高对于军团菌肺炎有一定的诊断价值,尤其SF水平增高>5倍时,诊断军团菌肺炎的可能性较大。

OBJECTIVE To observe the change of level of serum ferritin （SF） in the patients with Legionella pneumonia or other types of pneumonia before and after treatment and explore the value of SF in diagnosis of Legionella pneumonia. METHODS From Mar 2011 to Mar 2013, the clinical data were collected from 121 patients with pulmonary infections, among which 25 patients with conformed Legionella pneumonia were assigned as the Legionella pneumonia group, 84 patients with bacterial pneumonia as the bacterial pneumonia group, 7 patients with Mycoplasma pneumonia as the Mycoplasma pneumonia group, 5 patients with viral pneumonia as the viral pneumonia group, the levels of SF were determined by means of chemiluminescence method, the biochemical indicators were statistically analyzed and compared, and the statistical analysis was performed with the use of SPSS 12.0 software. RESULTS Before the treatment, the level of SF was （1589.3±254.9）ng/ml in the Legionella pneumonia group, （179.1±10.3） ng/ml in the bacterial pneumonia group, （139.8±15.9） ng/ml in the viral pneumonia group, （256.5±32.1） ng/ml in the Mycoplasma pneumonia group; after the treatment, the level of SF was （161.6 ±28.6） ng/ml in the Legionella pneumonia group, which was significantly decreased, as compared with other groups, the difference was significant （P〈0.01）; the other biochemical indicator, including erythrocyte sedimentation rate, C-reactive protein, serum sodium concentration, serum potassium concentration, serum transaminases, and CO2 combining power showed varying degrees of abnormalities, without specificity manifested. CONCLUSION The elevated level of SF has a certain value in diagnosis of Legionella pneumonia; especially when the level of SF increases more than 5 times than normal, the possibility of diagnosis of Legionella pneumonia is higher.