血清PCT、CRP、D-二聚体(FIB)联合检测对重症肺炎的早期诊断及预后评估的临床意义

Clinical Significance of Early Detection and Prognosis of Severe Pneumonia by Serum PCT, CRP and D-dimer(FIB)

目的:探讨C反应蛋白(CRP)、血清降钙素原(PCT)、D-二聚体(D-D)联合检测对重症社区获得性肺炎(CAP)的早期诊断及预后评估的临床意义。方法:收集2015年1月~2017年1月的100例重症肺炎患者作为研究对象,和50例健康体检人员的临床资料,CAP按肺炎严重指数(PSI)分组:重症CAP组与非重症CAP组,观察两组患者D-D、PCT、CRP水平变化及与健康对照组的比较。结果:重症CAP组患者PCT、CRP、D-D水平均明显高于非重症CAP组,且比较差异均有统计学意义(P<0.05);CAP组患者PCT、CRP、D-D水平均明显高于健康对照组,且比较差异均有统计学意义(P<0.05)。结论:CRP、PCT、D-二聚体水平与CAP的严重程度有关,CRP、D-二聚体水平的下降表示病情好转,病人有较好的预后。相反,CRP、D-二聚体水平持续升高或进行性增加则表明CAP病情的进展,提示患者预后不良,CRP、PCT、D-二聚体水平对社区获得性肺炎有重要的诊断价值,能判断病情的严重程度和疗效评估。

Objective： To investigate the clinical signifi- cance of C-reactive protein （CRP）, serum procalcitonin （PCT） and D-dimer （DD） in the early diagnosis and prognosis of se- vere community-acquired pneumonia （CAP）. Methods： The clinical data of 100 patients with severe pneumonia from Janu- ary 2015 to January 2017 were collected and the clinical data of 50 healthy subjects. CAP was divided into severe pneumonia group （PSI）： Severe CAP group and non-severe CAP group , To observe the changes in DD, PCT and CRP levels in the two groups and comparison with the healthy control group. Results： The levels of PCT, CRP and DD in CAP group were significant- ly higher than those in non-severe CAP group （P〈0.05）. The levels of PCT, CRP and DD in CAP group were significantly higher than those in healthy control group Group, and the differ- ence was statistically significant （P〈0.05）. Conclusion： The levels of CRP, PCT and D-direct are related to file severity of CAP. The decrease of CRP and D-dimer level indicates that the condition is improved and the patient has a better prognosis. On the contrary, CRP, D-dimer levels continued to increase or pro- gressive increase indicates that the progress of CAP, suggesting that patients with poor prognosis, CRP, PCT, D-dimer levels of community-acquired pneumonia has important diagnostic val- ue, Can determine the severity of the disease am｜ efficacy evalu- ation.