老年心力衰竭合并肺部感染患者血清降钙素原测定的临床意义

Measurement of serum procalcitonin level in elderly heart failure patients with pulmonary infection and its clinical significance

目的：探讨血清降钙素原（procalcitonin，PCT）检测在老年心力衰竭患者是否合并肺部感染中的临床意义。方法选取老年心力竭衰患者137例，根据有无肺部感染分为合并肺部感染组（感染组）66例和未合并肺部感染组（非感染组）71例，采用全自动荧光免疫分析仪动态监测血清PCT水平，同时分析肺部感染的情况。结果患者肺部感染率为48．2％。与非感染组比较，感染组PCT水平≥0．5μg/L比例明显升高（43．9％vs12．7％，P＜0．01）。PCT≥0．5μg/L预测肺部感染的敏感性、特异性、阳性预测值和阴性预测值分别为95．45％、81．69％、82．89％和95．01％。对PCT≥0．5μg/L的患者适当使用抗生素治疗3～14d后，PCT可降至＜0．5μg/L。结论血清PCT检测对老年心力衰竭患者肺部感染早期诊断及临床抗生素治疗有指导意义。

Objective To study the measurement of serum procalcitonin （PCT ） level in elderly heart failure patients with pulmonary infection and its clinical significance .Methods One hundred and thirty-seven heart failure patients were randomly divided into pulmonary infection group （n=66） and non-pulmonary infection group （n= 71） .Their ambulatory serum PCT level was moni-tored with an automatic flurescent immunoassay system and pulmonary infection was analyzed . Results The pulmonary infection rate was 48 .2% in elderly heart failure patients .The serum PCT level （≥0 .5μg/L）was significantly higher in pulmonary infection group than in non-pulmo-nary infection group （43 .9% vs 12 .7% ,P〈0 .01） .The sensitivity ,specificity ,positive and nega-tive predictive values of PCT ≥0 .5 μg/L were 95 .45% ,81 .69% ,82 .89% and 95 .01% ,respec-tively ,for pulmonary infection .The serum PCT level was 〈0 .5 μg/L in patients with their serum PCT level ≥0 .5 μg/L 3 -14 days after treatment with antibiotics .Conclusion Measurement of serum PCT level contributes to the early diagnosis of pulmonary infection and its treatment with antibiotics in elderly heart failure patients .