血清降钙素原和C反应蛋白检测在老年社区获得性肺炎患者中的应用价值

Application value of detection of serum procalcitonin and C-reactive protein in elderly patients with community acquired pneumonia

目的 探讨血清降钙素原(PCT)和C反应蛋白(CRP)检测在老年社区获得性肺炎(CAP)患者中的应用价值.方法 选取2016年10月至2017年12月我院呼吸内科收治的130例老年CAP患者为研究对象,按照CURB-65评分标准将患者分为高、中、低危险组.比较三组患者治疗前及治疗后3、7 d的血清PCT和CRP水平;比较细菌培养阳性组和阴性组血清PCT、CRP水平.结果 三组患者治疗前的PCT水平具有显著差异,其中低危组、中危组均明显低于高危组(P<0.05).治疗前,细菌培养阳性组的PCT水平明显高于细菌培养阴性组(P<0.05).治疗后3、7 d,三组患者的PCT、CRP水平均具有显著差异(P<0.05).三组患者治疗后7 d的PCT水平均低于治疗后3 d(P<0.05).低危组患者治疗后7 d的CRP水平明显低于治疗后3 d(P<0.05).结论 血清PCT和CRP水平检测在老年CAP的早期诊断及严重程度评估中具有重要作用.与CRP相比,治疗过程中动态检测PCT在评估抗感染疗效及指导抗菌药物使用中应用价值更高.

Objective To explore the application value of detection of serum procalcitonin (PCT) and C-reactive protein (CRP) in elderly patients with community acquired pneumonia (CAP). Methods A total of 130 elderly patients with CAP admitted in the respiratory department of our hospital from October 2016 to December 2017 were selected as the study objects. According to the CURB-65 score standard, all patients were divided into high-risk, medium-risk and low-risk groups. The levels of serum PCT and CRP before treatment and at 3, 7 d after treatment in the three groups were compared. The levels of serum PCT and CRP were compared between the bacterial culture positive and negative groups. Results There were significant differences in the levels of PCT among the three groups before treatment, and that in the low-risk group and the medium-risk group was significantly lower than the high-risk group (P<0.05). Before treatment, the level of PCT in the bacterial culture positive group was significantly higher than that in the bacterial culture negative group (P<0.05). At 3, 7 d after treatment, there were significant differences in the levels of PCT and CRP among the three groups (P<0.05). The levels of PCT at 7 d after treatment in the three groups were lower than those at 3 d after treatment (P<0.05). The level of CRP at 7 d after treatment in the low-risk group was significantly lower than that at 3 d after treatment (P<0.05). Conclusion The detection of serum PCT and CRP levels play important roles in the early diagnosis and severity assessment of elderly CAP patients. Compared with CRP, dynamic detection of PCT during treatment is more valuable in evaluating anti-infective efficacy and guiding the use of antibiotics.