PCT与CRP在社区获得性肺炎中的诊断价值

Diagnostic value of serum procalcitonin and C-reaction protein in community acquired pneumonia

目的探讨降钙素原(PCT)及C反应蛋白(CRP)在社区获得性肺炎临床诊断中的价值。方法选符合CAP诊断标准的患者89例,并分为重症肺炎组(A组)25例,一般肺炎组(B组)64例和18例(健康者)为对照组(C组),对入选患者的血清PCT和CRP进行分析。结果 PCT在A组为(14.770±6.141)ng/ml,B组(1.504±0.655)ng/ml、对照组(0.047±0.009)ng/ml,差异有统计学意义(P<0.05);而CRP虽然在重症肺炎组中明显升高,且其敏感性较PCT高,但其特异性较PCT低;取0.11ng/ml为截断值,降钙素原诊断社区活动性肺炎中的敏感度为88%,特异度为95%。结论降钙素原在社区获得性肺炎诊断中具有重要价值,尤其对重症肺炎诊断及病情严重程度评估,是一个可靠的指标。

Objective To evaluate the value of serum procalcitonin （PCT） and C-reaction protein （CRP） in clinical diagnosis of community acquired pneumonia. Methods From January 2012 to September 2013, a total of 107 patients include 89 patients with CAP and 18 controls were assigned into three groups： 25 severe pneumonia patients, 64 mild pneumonia patients and 18 controls. The levels of serum PCT and CRP, number of white blood cells, percentage of neutrophils were measured after admission. Results The serum PCT level was （14.770±6.141） ng/ml in severe pneumonia patients, which was significantly higher than that in mild pneumonia patients （130±17.350） ng/ml and controls （83.670±8.047） ng/ml （P〈0.05）. Although the CRP level was higher in pneumonia patients, and their sensitivity was taller than PCT, their specificity were lower than those of PCT. PCT had a good diagnostic value to pneumonia, with the optimal cut-off of 0.11ng/ml, the sensitivity of 88% and the specificity of 95%. Conclusion Serum PCT plays an important diagnosis value in community acquired pneumonia and assessment of its severity, especially in severe pneumonia, thus it could be used as an effective indicator.