血清降钙素原检测在重症感染肺炎早期诊断的应用探讨

Application of Serum Procalcitonin Detection in Early Diagnosis of Severe Pneumonia

目的探讨血清降钙素原(PCT)检测在重症感染肺炎早期诊断的应用价值。方法选取荣成市人民医院呼吸内科2015年3月—2016年2月收治的104例痰培养阳性肺炎患者作为研究对象,将50例重症细菌性肺炎患者作为重症感染组,将54例轻症细菌性肺炎患者作为轻症感染组,对比患者均抗生素使用前血清PCT检测浓度。以10.0 ng/ml及以上、2.0~10.0 ng/ml、0.5~2.0 ng/ml、0.02~0.5 ng/ml进行分段,PCT=2.0 ng/ml为截断值,判断PCT对重症感染的诊断价值。结果两组患者血清PCT在4个分段中的情况对比,差异具有统计学意义(P<0.05)。PCT=2.0 ng/ml为截断值,重症感染组PCT≥2.0ng/ml患者比例占82.00%,轻症感染组PCT≤2.0 ng/ml患者比例占51.85%。以PCT=2.0 ng/ml为截断值,计算其对诊断重症感染肺炎的灵敏度为82.00%(41/50),特异性为51.85%(28/54),阳性预测值为61.19%(41/67),阴性预测值为75.68%(28/37)。结论 PCT在重症感染肺炎和轻症感染肺炎时的检测值存在明显差异,以PCT=2.0 ng/ml作为截断值对重症感染肺炎早期诊断有一定的应用价值。

Objective To investigate the application value of serum procalcitonin（PCT） in early diagnosis of severe pneumonia. Methods 104 cases of sputum culture positive pneumonia were selected from March 2015 to February 2016 in respiratory department of Rongcheng people＇s hospital were selected as the study object. 50 cases of patients with severe bacterial pneumonia as severe infection group, 54 cases of patients with mild bacterial pneumonia were treated as mild infection group, serum concentrations of PCT were detected in patients before and after antibiotic use. Above 10.0 ng/ml, 2.0 ~ 10.0 ng/ml, 0.5 ~ 2.0 ng/ml, 0.02 ~ 0.5 ng/ml segment, PCT=2.0 ng/ml as the cut-off value, the value of PCT in diagnosis of severe infection. Results The serum PCT levels of two groups were compared in the 4 segments, the difference was statistically significant（P〈0.05）. PCT=2.0 ng/ml as the cut-off value, severe infection group PCT ≥ 2.0 ng/ml patients accounted for 82.00%, mild infection group PCT ≤ 2.0 ng/ml patients accounted for 51.85%. Taking PCT = 2.0 ng/ml as cutoff value, the sensitivity was 82.00%（41/50） in the diagnosis of severe pneumonia, the specificity was 51.85%（28/54）, the positive predictive value was 61.19%（41/67）, the negative predictive value was 75.68%（28/37）. Conclusion There is a significant difference in the detection value of PCT in severe pneumonia and mild pneumonia, and PCT=2.0 ng/ml as a cut-off value has a certain value in the early diagnosis of severe pneumonia.