血清降钙素原对老年肺炎诊疗的作用

Evaluation of procalcitonin role in the diagnosis and treatment of elderly patients with pneumonia

目的评定血清降钙素原(PCT)在老年肺炎诊疗中的价值。方法选择明确诊断老年肺炎患者100例作为观察组,将其分为细菌组(A组)、病毒组(B组)、支原体组(C组)同时分别测定炎性指标包括PCT、CRP、血常规参数值。细菌组分为PCT组(A1组)、对照组(A2组),A1组以PCT参数值变化作为指导抗生素使用,A2组应用常规方法使用抗生素治疗。比较A1组、A2组抗生素使用时间,临床有效率,住院时间,转化为重症肺炎例数等,同时测定第4天、第7天、第10天的炎性指标。结果 A组PCT水平升高幅度最大,B组与C组升高不明显,对细菌感染的灵敏度和特异度较高。A1、A2两组有效治疗后炎症指标较治疗前均降低,A1组抗生素使用时间,临床有效率,住院时间,转化为重症肺炎例数明显低于A2组,差异有统计学意义(P<0.05)。结论 PCT对老年肺炎病原学判别和诊疗中有重要临床价值,较CRP等传统炎性指标有较高的敏感性和特异性,值得临床推广应用。

Objective To evaluate the value of serum procalcitonin （PCT） diagnosis and antibiotic treatment in elderly patients with pneumonia. Methods 100 elderly patients with pneumonia were selected as the observation group, and then were divided into the bacteria group （the group A）, the virus group （the group B）, and the mycoplasma （the group C）. The inflammatory markers including PCT, CRP and WBC parameter values were measured at the same time. The bacteria group was divided into the PCT group （A1） and the control group （group A2）. The level of PCT in the group A1 was to guide antibiotic use. Time of antibiotics use, clinical efficiency, and duration of hospital stay were analyzed. Results The level of PCT increased the most in the group A, showing a high sensitivity and specificity to bacterial infection. After effective treatment, the improvement of inflammatory markers, clinical efficiency, and duration of hospital stay was more pronounced in the group A1 than in the group A2 （P〈0.05）. Conclusion PCT has important clinical value in diagnosis and treatment of elderly patients with pneumonia.