PCT、HS-CRP和FIB检测在肺结核治疗中的意义

Significance of detection of PCT,HS-CRP and FIB in the treatment of pulmonary tuberculosis

目的探讨肺结核患者血清降钙素原(PCT)、超敏C反应蛋白(HS-CRP)和血浆纤维蛋白原(FIB)检测的临床意义。方法选取52例痰菌涂片阳性或痰TB-PCR阳性肺结核患者作为A组、55例痰菌涂片阴性且痰TB-PCR阴性肺结核患者作为B组,测定两组患者治疗前和治疗3个月PCT、HS-CRP、FIB水平变化;选择30例健康体检人群作对照组。结果两组治疗前PCT、HS-CRP和FIB水平均显著高于对照组(P<0.05),其中A组HS-CRP水平显著高于B组(P<0.05)。两组治疗后PCT、HS-CRP和FIB水平均显著低于治疗前(P<0.05),其中B组上述三项指标与对照组比较均无显著差异(P>0.05),A组HS-CRP、FIB水平仍显著高于对照组(P<0.05)。结论肺结核患者PCT水平恢复早于HS-CRP和FIB,但敏感性低;HS-CRP和FIB水平随治疗进程而发生变化,可用于辅助临床进行病情转归的判定。

Objective To explore the clinical significance of detection of PCT, HS-CRP and FIB in serum in the treatment of pulmonary tuberculosis. Methods It selected 52 patients with positive sputum smear or TB-PCR as the group A and 55 patients with negative sputum smear or TB-PCR as the group B. The levels of PCT, HS-CRP and FIB were detected at the beginning of treatment and 3 months after the treatment. At the same time, 30 healthy people were selected as the control group. Results The levels of PCT, HS-CRP and FIB were significantly higher in the group A and B than in the control group before the treatment （P〈0. 05）, and the level of HS-CRP was signifi-cantly higher in the group A than in the group B （P〈0. 05）. 3 months after the treatment, the levels of PCT, HS-CRP and FIB decreased more obviously than before in the group A and B, but they had no significant difference be-tween the group B and the control group （P〉0. 05）. The levels of HS-CRP and FIB were significantly higher in the group A than in the control group （P〈0. 05）. Conclusion The speed of decline and recovery of PCT is more quickly than that of HS-CRP and FIB, but the sensitivity is low. The change of HS-CRP and FIB levels with the treatment process can be used to evaluate their clinical prognosis.