降钙素原水平检验在老年心衰合并肺部感染诊断中的应用价值

The Value of Procalcitonin Level Test in the Diagnosis of Senile Heart Failure Complicated with Pulmonary Infection

目的探讨降钙素原(PCT)水平检验在老年心衰合并肺部感染诊断中的应用价值。方法方便选取该院2016年8月—2017年8月接诊的60例老年心衰合并肺部感染患者、60例单纯心衰患者、60例单纯肺部感染患者和60名健康体检者作为研究对象,对4组研究对象进行血清PCT检验,对比、分析检验结果。结果正常组的PCT水平最低(0.04±0.03)ng/mL,心衰合并感染组的PCT水平最高(0.18±0.39)ng/mL,显著高于另外3组,差异有统计学意义(P<0.05),单纯感染组的PCT水平为(0.12±0.23)ng/mL,显著高于单纯心衰组的(0.08±0.02)ng/mL差异有统计学意义(P<0.05)。PCT浓度为<0.05 ng/mL时,对心衰合并肺部感染的诊断灵敏度及阴性预测值最高(93.5%、73.6%),但诊断特异度及阳性预测值较低(28.5%、54.3%),随着PCT浓度的升高,PCT对心衰合并肺部感染的诊断特异度及阳性预测值逐渐升高,而诊断灵敏度和阴性预测值逐渐降低。PCT浓度为﹥2.0μg/L时,PCT对心衰合并肺部感染的诊断特异性及阳性预测值最高(98.1%、91.2%)。结论血清PCT检验对老年心衰合并肺部感染有较高的诊断价值,早期进行PCT检验可为临床诊断肺部感染提供参考依据。

Objective To investigate the value of procalcitonin(PCT)level test in the diagnosis of senile heart failure complicated with pulmonary infection.Methods 60 elderly patients with heart failure and pulmonary infection,60 patients with simple heart failure,60 patients with simple lung infection and 60 healthy subjects were convenient selected and enrolled in the study.Serum PCT was performed on 4 groups of subjects.Test,compare and analyze the test results.Results The PCT level in the normal group was the lowest(0.04±0.03)ng/mL,and the PCT level in the heart failure group was the highest(0.18±0.39)ng/mL,which was significantly higher than the other 3 groups,the different was statistically significant(P<0.05).The PCT level was(0.12±0.23)ng/mL,which was significantly higher than that of the simple heart failure group(0.08±0.02)ng/mL,the different was statistically significant(P<0.05).When the PCT concentration was<0.05ng/ml,the diagnostic sensitivity and negative predictive value of heart failure with lung infection were the highest(93.5%,73.6%),but the diagnostic specificity and positive predictive value were lower(28.5%,54.3%).With the increase of PCT concentration,the diagnostic specificity and positive predictive value of PCT for heart failure with pulmonary infection gradually increased,while the diagnostic sensitivity and negative predictive value gradually decreased.When PCT concentration was>2.0μg/L,PCT had the highest diagnostic specificity and positive predictive value for heart failure with pulmonary infection(98.1%,91.2%).Conclusion Serum PCT test has a high diagnostic value for elderly patients with heart failure and pulmonary infection.Early PCT test can provide a reference for clinical diagnosis of pulmonary infection.