血清降钙素原对老年社区获得性肺炎的诊断及预后预测价值

Predictive value of serum procalcitonin in diagnosis and prognosis for aged patients with community- acquired pneumonia

目的探讨血清降钙素原对老年社区获得性肺炎(CAP)的诊断及预后评估价值。方法选取老年CAP患者76例为研究组,同期60岁以上无CAP体检者55例为对照组。收集研究组痰液进行细菌培养,并检测2组血清降钙素原(PCT)水平及白细胞计数(WBCC)、C-反应蛋白(CRP)等炎症指标。结果研究组入院时及治疗第1、4天,WBCC、CRP及PCT水平均显著高于对照组(P<0.01);研究组入院时PCT水平在痰培养阴性及阳性者间差异有统计学意义(P<0.05);研究组治疗后存活者入院时PCT水平显著低于死亡者(P<0.01)。结论 PCT能够在一定程度上预测老年CAP患者痰培养结果及治疗结局,敏感性优于CRP和WBCC,对老年CAP的诊断及预后预测有一定的价值。

Objective To explore the value of serum procalcitonin in diagnosis and prognosis for aged patients with community- acquired pneumonia（ CAP）. Methods Seventy- six patients with CAP were selected as research group and 55 patients without CAP of more than 60 years old at the corresponding period who underwent physical examination were selected as control group. Sputum in research group was collected for bacterial culture,and the serum procalcitonin（ PCT） level,white blood cell count（ WBCC）,and the level of C- reactive protein（ CRP） of 2 groups were detected.Results The levels of CRP and PCT and WBCC were higher in research group than those in control group on admission and on the 1st,4thday of treatment（ P〈0. 01）. There was statistical difference in the level of PCT between negative and positive sputum（ P〈0. 05）. In research group,the level of PCT in survivor was significantly lower than that in the dead after treatment（ P〈0. 01）. Conclusion PCT,to some extent,is superior to CRP and WBCC in predicting the sputum culture results and treatment outcomes for aged patients with CAP,so it has certain value in diagnosis and prognosis for aged patients with CAP.