降钙素原对急性心肌梗死患者心功能不全与肺部感染的鉴别诊断价值

Effects of procalcitonin in acute myocardial infarction patients with heart failure and pulmonary infection of the differential diagnosis value

目的探讨血清降钙素原(PCT)对急性心肌梗死(AMI)患者心功能不全与合并肺部感染的鉴别诊断价值。方法应用荧光酶联免疫技术测定70例AMI心功能不全合并肺部感染者(感染组)及72例非感染者(对照组)的PCT,同时测定患者血常规、B型钠尿肽前体、C反应蛋白(CRP)、心脏彩超及肺部CT或胸部X线平片;应用ROC曲线评价检测指标诊断效能。结果白细胞数(WBC)、CRP、PCT感染组与对照组阳性率分别为(91.4%vs 77.8%)、(65.7%vs 38.9%)、(88.6%vs 8.3%)。PCT的敏感性为82.9%,特异性94.4%,诊断价值最大。结论 AMI出现咳嗽、气喘及肺部罗音时,PCT可作为早期快速鉴别心功能不全与肺部感染的实验室指标,指导抗生素合理使用。

Objective To investigate the effects of serum procalcitonin in acute myocardial infarction（AMI）patients with heart failure and pulmonary infection of the differential diagnosis value.Methods The serum PCT of two groups of patients were measured with the fluorescent enzyme immunoassay technique.One of the two groups was 70 cases of AMI patients with heart failure and pulmonary infection（infection group）,and the other group was 72 cases of AMI with heart failure（control group）.Simultaneous determination of blood routine,NT-proBNP and C-reactive protein（CRP）,echocardiography and pulmonary CT image or chest X-ray plain film.application of receiver operating characteristic（ROC）curve evaluate the diagnostic efficiency of each indiactor.Results For the white blood cells（WBC）,CRP and PCT positive rate,infection group were 91.4%,65.7% and 88.6% respectively,control group rate were77.8%,38.9% and 8.3% respectively.The rate of PCT diagnostic sensitivity and specificity were 82.9% and 94.4%respectively,the diagnosis had the best effect.Conclusion When there was the cough,asthma and lung rale in AMI patients,the PCT may contribute to identification of heart failure and pulmonary infection laboratory indicators early and rapidly,which may be helpful for reasonable application of antibiotics.