降钙素原与C反应蛋白在诊断呼吸机相关肺炎中的临床价值

Clinical value of procalcitonin and C-reactive protein in the diagnosis of ventilator associated pneumonia

目的探讨血清降钙素原(Procalcitonin,PCT)与C反应蛋白水平对呼吸机相关性肺炎诊断中的价值。方法回顾性分析我院2011年2月至2014年12月121例使用有创呼吸机辅助通气的患者,根据1天、3天、7天是否发生呼吸机相关肺炎(ventilator associated pneumonia,VAP),分两组:VAP组58例,非VAP组63例,分析血清PCT、CRP在早期诊断中的临床意义。结果机械通气前、1天两组PCT水平比较无统计学差异(P>0.05),机械通气后VAP组3天、7天的PCT水平明显高于非VAP组(P<0.05)。两组机械通气前及1天、3天的CRP比较差异无统计学意义(P>0.05);机械通气后VAP组7天CRP水平明显高于非VAP组(P<0.05)。结论血清PCT有助于VAP的早期诊断。

Objective To investigate the value of serum PCT and C- reactive protein in diagnosis of ventilator associated pneumonia.Methods Reviewed the datas of 121 cases of patientswho ever used mechanical ventilation during February 2011 and December 2014,and divided these patients into two groupsaccording to the occurrence of ventilator associated pneumonia（VAP） occurs in the 1st,3rd and 7th day,VAP group consisted of58 casesand non- VAP group consisted of 63 cases,and analyze the value of PCT and CR in the earlydiagnosis.Results The difference of PCT level between the two groups was not statistically significant at the time point before using mechanical ventilationand one day after using mechanical ventilation（P 〉 0.05）.The PCT level of VAP group was obviously higher than that of non- VAP group three or seven days afterthe useof mechanical ventilation（P 〈0.05）.Before mechanical ventilation and one or three days after using mechanical ventilation,the CRP level of two groups had no significant difference（P 〉 0.05）.Seven days after the using mechanical ventilation,CRP level of VAP group was obviously higher than that of the non- VAP group（P 〈 0.05）.Conclusions The serum PCT was helpful for early diagnosis of VAP.