血乳酸、降钙素原、C反应蛋白在老年社区获得性肺炎患者中的变化及临床意义

The changes and clinical significance of blood lactic acid, PCT, CRP in elderly patients with communityacquired pneumonia

目的探讨老年社区获得性肺炎患者血清C反应蛋白(CRP)、降钙素原(PCT)、血乳酸水平及临床应用价值。方法选取2014年6月至2015年6月本院呼吸内科收治的84例社区获得性肺炎患者纳入肺炎组,另选取同期80例健康体检者纳入对照组,分析血清CRP、PCT、血乳酸在社区获得性肺炎患者中的变化及应用价值。结果肺炎组患者CRP、PCT、血乳酸水平均显著高于对照组(P<0.05)。84例老年社区获得性肺炎患者经对症治疗后,存活72例,死亡12例,死亡率为14.29%。死亡组患者血清CRP、PCT、血乳酸水平显著高于存活组(P<0.05)。经ROC分析显示,灵敏度:PCT>血乳酸>CRP;特异性:PCT>血乳酸>CRP,血乳酸+PCT+CRP联合诊断时灵敏度及特异性均高于单一指标诊断。结论老年社区获得性肺炎患者血清中CRP、PCT、乳酸水平均显著高于健康人群,通过测定血清CRP、PCT、血乳酸水平可有效评价患者预后,三种指标联合检测可提高其在临床中的应用价值。

Objective To investigate the changes and clinical significances of the levels of C-reactive protein（CRP）, procalcitonin（PCT）, blood lactic acid of elderly patients with community acquired pneumonia. Method 84 cases of community acquired pneumonia patients from June 2014 to June 2015 treated in our hospital respiratory medicine were chosed as pneumonia group. Another 80 healthy subjects were included in control group. The changes and application value of serum CRP, PCT, blood lactic acid in patients with community acquired pneumonia were analyzed. Result The levels of serum CRP, PCT, blood lactic acid of pneumonia group patients were significantly higher than control group（P 0.05）. 84 cases of elderly patients with community acquired pneumonia after symptomatic treatment, 72 cases survived, 12 cases died, the mortality rate was 14.29%. The levels of serum CRP, PCT, blood lactic acid in death group was significantly higher than survival group（P 0.05）. By ROC analysis, sensitivity： PCT blood lactic acid CRP; specificity： PCT blood lactic acid CRP, blood lactic acid ＋ PCT ＋ CRP joint diagnosis sensitivity and specificity were higher than single diagnostic indicator. Conclusion The levels of CRP, PCT and blood lactic acid in the serum of elderly patients with acquired pneumonia are significantly higher than healthy people, through the determination of serum CRP, PCT, blood lactic acid levels can effectively evaluate the prognosis of patients, the combined detection of three indexes can improve their clinical application value.