超敏C反应蛋白、前清蛋白及降钙素原在重症肺炎患者中的变化及诊断的临床意义

Changes of Hypersensitive C-reactive Protein,Proalbumin and Procalcitonin in Patients with Severe Pneumonia and Its Clinical Significance

目的探讨血清超敏C反应蛋白、前清蛋白及降钙素原联合检测在重症肺炎患者中的变化及诊断的临床意义。方法选取2017年6月～2018年5月我院呼吸内科收治的肺炎患者70例作为研究对象,依据病情分为重症肺炎组与非重症肺炎组,同时选取30例健康体检者作为对照组,对比各组血清hc-CRP、PA及PCT结果并进行分析。结果重症肺炎组血清hc-CRP及PCT水平分别为(15.44±1.76)mg/L、(0.92±0.22)ng/ml,高于非重症肺炎组(9.24±1.14)mg/L、(0.67±0.15)g/ml和对照组(2.66±0.26)mg/L、(0.16±0.02)g/ml (P<0.05),血清PA (87.62±6.74)mg/L低于非重症肺炎组(165.49±21.26)mg/L和对照组(297.54±34.63)mg/L(P<0.05),非重症肺炎组与对照组相比,血清hc-CRP、PA及PCT差异具有统计学意义(P<0.05);PCT敏感度最高,PA特异性最高,三项联合检测阳性率高于单项检测。结论 hc-CRP、PA及PCT对于重症肺炎诊断均有一定的临床诊断及鉴别诊断意义,并且三项联合检测可提高敏感度和特异性。

Objective To investigate the clinical significance of serum hypersensitive C-reactive protein,prealbumin and procalcitonin in the diagnosis of severe pneumonia.Methods70patients with pneumonia admitted to our hospital from June2017to May2018were selected as subjects.According to the condition,they were divided into severe pneumonia group and non-severe pneumonia group.30healthy subjects were selected as the control group.Serum hc-CRP,PA and PCT results were analyzed and analyzed.Results The serum hc-CRP and PCT levels in severe pneumonia group were(15.44±1.76)mg/l,(0.92±0.22)ng/ml,higher than those in non-severe pneumonia group which were(9.24±1.14)mg/L,(0.67±0.15)g/ml respectively and(2.66±0.26)mg/l,(0.16±0.02)g/ml in control group(P<0.05).Serum PA(87.62±6.74)mg/L was lower than that in non-severe pneumonia group(165.49±21.26)mg/l and control group(297.54±34.63)mg/L(P<0.05).Compared with the control group,the serum hc-CRP,PA and PCT in the non-severe pneumonia group were significantly different(P<0.05).The sensitivity of PCT was the highest,the specificity of PA was the highest,and the positive rate of three combined tests was higher than that of single test.Conclusion Both hc-CRP,PA and PCT have some clinical and differential diagnostic significance in the diagnosis of severe pneumonia,and the combined detection can improve the sensitivity and specificity.