降钙素原检测在心力衰竭患者肺部感染诊断中的临床意义

Clinical significance of procalcitonin detection for lung infection in patients with heart failure

目的探讨降钙素原(proclacitonin,PCT)检测在心力衰竭患者肺部感染诊断中的临床应用价值。方法选取铜川矿务局中心医院2012年2月至2014年11月期间所收治的心力衰竭患者94例,依据患者肺部感染发生与否,分为感染组50例和未感染组44例。另选同期在我院进行健康体检的正常对照组50名。比较分析各组血清PCT和C反应蛋白(C-reactive protein,CRP)浓度、阳性检测率以及阳性和阴性预测值。结果与对照组健康人群相比,未感染组心力衰竭患者和感染组心力衰竭患者血清PCT和CRP浓度均有所提高,但感染组血清PCT和CRP浓度与对照组比较,差异具有统计学意义(P<0.05)。与未感染组比较,感染组血清PCT和CRP浓度明显提高,PCT和CRP阳性率均明显提高,分别达到88.00%和78.00%,差异均具有统计学意义(P<0.05)。对于心力衰竭合并肺部感染患者而言,与CRP相比,PCT阳性预测值和阴性预测值均明显提高,可达89.74%和92.23%,差异均具有统计学意义(P<0.05)。结论 PCT检测对于肺部感染合并心力衰竭患者的诊断具有重要的意义,为患者的进一步治疗提供了参考性价值。

Objectives To probe into clinical application value of procalcitonin （PCT） detection for lung infection in patients with heart failure. Methods From February 2012 to November 2014, 94 heart failure patients were selected in Mining Bureau Central Hospital of Tongchuan. According to the patients with or without lung infection, they were divided into infection group （n=50） and uninfected group （n=44）. Fifty healthy normal subjects were selected in our hospital during the same period as control group. Serum concentrations of PCT and C-reactive protein （CRP）, positive detection rate, positive and negative predictive values of the patients were compared and analyzed. Results Compared with the healthy normal subjects in control group, serum concentrations of PCT and CRP in heart failure patients increased, and there was a statistical difference between infected group and control group （P〈0.05）. Compared with patients in uninfected group, serum concentrations of PCT and CRP in infected group increased statistically, positive detection rates of PCT and CRP increased significantly, up to 88.00% and 78.00%, the differences were significant （P〈0.05）. For heart failure patients with pulmonary infection, compared with CRP, positive predictive value and negative predictive value of PCT increased significantly, up to 89.74% and 92.23%, the differences were significant （P〈0.05）. Conclusions Detecting PCT for the diagnosis of pulmonary infection in patients with heart failure has a significant value. It provides a reference to further treatment for patients.