降钙素原在肺结核与肺炎鉴别诊断中的价值

Value of serum procalcitonin in the identification between pulmonary tuberculosis and bacterial pneumonia

目的探讨血清降钙素原(PCT)对肺结核与细菌性肺炎的鉴别诊断价值。方法应用酶联免疫荧光法对48例活动性肺结核、64例细菌性肺炎患者行血PCT、白细胞(WBC)及C反应蛋白(CRP)检测,对结果进行比较,评价这些指标对上述两种疾病的鉴别诊断价值。结果肺炎组血清PCT、WBC及CRP均明显高于结核组(P<0.01),受试者工作特征曲线(ROC)下面积(AUC)分别为0.953、0.868、0.775,取最佳切点时鉴别这两种疾病的灵敏度分别为0.938、0.781、0.750,特异度分别为0.875、0.875、0.729。结论血清PCT是鉴别细菌性肺炎和肺结核的有效指标,且优于WBC和CRP。

Objective To explore the differential value of procalcitonin between pulmonary tuberculosis and bacterial pneumonia. Methods Immunofluorescence was used to detect the serum PCT in 48 patients with active pulmonary tuberculosis and 64 patients with bacterial pneumonia. Meanwhile, the level of white blood cell （ WBC） and c-reactive protein （ CRP） were detected. The differential value of these inflammation indexes was evaluated for the two diseases above according to receiver operating characteristic curve （ ROC ） . Results The levels of serum PCT, WBC and CRP were significantly higher in the bacterial pneumonia group than in the pulmonary tuberculosis group （P〈0. 01）. The AUC of ROC curves was 0. 953, 0. 868 and 0. 775 respectively. The sensitivity of the two diseases was 0. 938, 0. 781 and 0. 750 by taking the optimum point of tangency. The specificity was 0. 875, 0. 875 and 0. 729. Conclusion The serum PCT is an efficiency index for differentiating bacterial pneumonia and pulmonary tuberculosis, which is superior to WBC and CRP.