降钙素原在早期危重症患者呼吸机相关性肺炎中水平改变的意义

Significance of Procalcitonin in Critically Ill Patients with Ventilator Associated Pneumonia

目的探讨降钙素原在早期危重症患者呼吸机相关性肺炎水平改变意义。方法选择我院实施机械通气治疗的危重患者共72例,其中40例诊断为呼吸机相关性肺炎,作为呼吸机相关性肺炎组,其余32例为非呼吸机相关性肺炎,作为非呼吸机相关性肺炎组,检测上述两组降钙素原、C反应蛋白和白细胞水平。呼吸机相关性肺炎组治疗5 d后根据临床肺炎感染评分,分为恶化组和好转组,测定两组降钙素原水平。结果呼吸相关性肺炎组降钙素原、C反应蛋白和白细胞水平均高于非呼吸机相关性肺炎组,差异有统计学意义(P<0.05)。好转组降钙素原水平及临床肺部感染评分均低于恶化组,差异有统计学意义(P<0.05)。结论了解血清降钙素原水平改变有助于呼吸机相关性肺炎早期诊断,有助于判断呼吸机相关性肺炎病情,具有重要临床意义。

Objective To explore the significance of procalcitonin in critically ill patients with ventilator associated pneumonia. Methods 72 cases critically ill patients with mechanical ventilation was selected in our hospital, of which 40 cases were diagnosed as ventilator-associated pneumonia group, as ventilatorassociated pneumonia group, and 32 cases of non ventilator associated pneumonia, as non-ventilator-associated pneumonia group. The procalcitonin, C-reactive protein and white blood cell level in the two groups were detected. After 5 days of treatment, the patients with ventilator-associated pneumonia（VAP） were divided into two groups according to the scores of clinical pneumonia infection, deterioration group and improvement group, and the level of procalcitonin in the two groups was measured. Results The levels of procalcitonin, C reactive protein and white blood cell（WBC） in ventilator-associated pneumonia group were significantly higher than those in non ventilator associated pneumonia group, the difference was statistically significant（P〈0.05）. The procalcitonin level and clinical pulmonary infection score in the improvement group were lower than those in the deteriorated group, and the difference was statistically significant（P〈0.05）. Conclusion It is important to understand the change of serum procalcitonin level in early diagnosis of ventilator associated pneumonia, which is helpful to judge the condition of ventilator-associated pneumonia.