降钙素原在重症肺炎并发弥散性血管内凝血诊断中的作用

The diagnosis value of procalcitonin in severe pneumonia complicated with disseminated intravascular coagulation

目的探讨降钙素原(PCT)在重症肺炎并发弥散性血管内凝血(DIC)诊断中的作用。方法选取惠州市第一人民医院呼吸内科重症肺炎患者79例,根据是否合并弥散性血管内凝血将患者分为研究组(合并DIC,DIC评分≥5分)和对照组(未合并DIC,DIC评分<5分),采用酶联免疫荧光法测定血清PCT水平,比较两组血清PCT水平和DIC评分,分析血清PCT水平与重症肺炎并发DIC及其凝血指标的关系。结果研究组血清PCT水平和DIC评分均明显高于对照组,两组比较差异有统计学意义(P<0.05);血清PCT<2.0 ng/ml重症肺炎患者DIC并发症发生率为12.66%(10/79),血清PCT≥2.0 ng/ml重症肺炎患者DIC并发症发生率为37.97%(30/79),两者比较差异有统计学意义(P<0.01)。经Pearson相关性分析显示,血清PCT水平与外周血血小板计数、D-二聚体呈明显的正相关(r=0.512,P<0.05;r=0.496,P<0.05)。结论血清PCT水平在重症肺炎并发弥散性血管内凝血患者中显著增高,可能通过影响重症肺炎凝血功能参与DIC发生和发展的过程。

Objective To investigate the diagnosis role of procalcitonin（PCT） in severe pneumonia（SP） complicated with disseminated intravascular coagulation（DIC）. Methods 79 cases of severe pneumonia patients in department of respiratory internal medicinein our hospital were selected,according to whether complicated with DIC, the patients were divided into study group（with DIC, DIC score ≥5 points） and control group（non DIC, DIC score 5 points）, serum PCT levels were detected by enzyme linked immunosorbent assay;serum PCT and DIC scoreswere compared between the two groups. The relationship between serum PCT levels and severe pneumonia complicated with DIC and coagulation index were analyzed. Results The serum PCT levels and DIC scores were significantly higher than those of control group（P〈0.05）. Serum PCT2.0 ng / ml severe pneumonia complicated with DIC occurred rate was 12.66%（10 / 79）, serum PCT ≥2.0 ng / ml severe pneumonia complicated with DIC occurred rate was 37.97%（30 / 79）;the occurred rates had significant difference（P〈0.01）. The pearson correlation analysis showed that serum PCT level was positivelycorrelatedwith peripheral blood platelet count（r=0.512,P〈0.05）; serum PCT level was positively correlated with D-dimer（r=0.496,P〈0.05）. Conclusions Serum procalcitonin levels were significantly higher in the severe pneumonia than those in patients with disseminated intravascular coagulation.High serum procalcitonin levels may be involved in the occurrenceand development of.Serum PCT could be an important diagnostic index for SP complicated with DIC.