细菌性肺炎患者血清CRP、PCT检测的临床意义及危险因素分析

Serum C-Reactive Protein and Procalcitonin Levels in Patients with Bacterial Pneumonia:Clinical Significance and Risk Factors

目的探讨细菌性肺炎患者血清C-反应蛋白(C-reactive protein,CRP)、降钙素原(procalcitonin,PCT)检测的临床意义及危险因素。方法选择82例细菌性肺炎患者(研究组)和63例支气管哮喘患者(对照组),分别检测2组血清CRP、PCT的水平。收集细菌性肺炎患者的并发症[心血管疾病、脑血管疾病,发热(T≥38℃)、休克]资料,并对细菌性肺炎的危险因素采用多因素非条件Logistic回归分析。结果与对照组比较,研究组血清CRP、PCT水平均显著升高(均P<0.05)。发热(T≥38℃,OR=2.341,95%CI 1.298~5.342,P<0.01)、心血管疾病(OR=1.776,95%CI1.015~3.628,P<0.05)、脑血管疾病(OR=1.994,95%CI 1.015~3.307,P<0.05)、休克(OR=3.038,95%CI3.201~7.179,P<0.01)、血清CRP水平(OR=4.825,95%CI4.118~18.784,P<0.01)、血清PCT水平(OR=6.336,95%CI5.720~26.911,P<0.01)均为细菌性肺炎的危险因素。结论细菌性肺炎患者血清CRP、PCT水平均升高,可作为临床细菌性肺炎诊断的指标之一。发热(T≥38℃)、心血管疾病、脑血管疾病、血清CRP升高、血清PCT升高均为细菌性肺炎的危险因素,应及早采取干预措施,预防并发症的发生。

Objective To explore the clinical significance and risk factors of serum C-reactive protein（CRP） and procalcitonin（PCT） levels in patients with bacterial pneumonia. Methods Ser-um CRP and PCT levels were measured in 82 patients with bacterial pneumonia（study group） and 63 patients with bronchial asthma （control group）. Clinical data on complications of bacterial pneumonia（cardiovascular disease,cerebrovascular disease,fever（T^38℃） and shock） were col-lected, and the risk factors for bacterial pneumonia were analyzed by the unconditional multivari-ate logistic regression. Results Compared with control group, serum CRP and PCT levels signifi-cantly increased in study group（P〈0 . 05）. The risk factors for bacterial pneumonia included the fever（T^38 ℃ ,OR -2. 3 4 1 ,95%CJ 1. 298-5. 342 , P〈0. 01） ？cardiovascular disease（OR = 1. 776, 95 % CI 1. 015-3. 628, 0. 05）,cerebrovascular disease （OR = 1. 994,95% CI 1. 015-3. 307,0 .05） , shock（QR = 3. 038,95 %CI 3. 201-7. 179 , P〈0. 01） , serum CRP levels（QR = 4. 825,95 % CI 4. 118-18. 784,P〈0. 01） ,and serum PCT levels（OR = 6. 336,95%CI 5. 720-26. 911,P〈0. 01）. Conclusion Patients with bacterial pneumonia have increased serum levels of CRP and PCT, which can be used as the diagnostic indicators of bacterial pneumonia. The fever（T≥38℃） ,cardi-ovascular disease, cerebrovascular disease and increase in CRP and PCX levels are the risk factors for bacterial pneumonia. Early intervention should be carried out to prevent the occurrence of complications of bacterial pneumonia.