163例社区获得性肺炎患者白细胞计数C-反应蛋白血清淀粉样蛋白A和降钙素原的诊断价值评价

Evaluation of diagnostic value of WBC,CRP,SAA and PCT in 163 patients with community acquired pneumonia

目的:探讨白细胞计数(WBC)、C-反应蛋白(CRP)、血清淀粉样蛋白A(SAA)、降钙素原(PCT)在社区获得性肺炎诊治中的价值。方法:回顾性分析163例社区获得性肺炎住院患者,以临床症状结合影像学X线、CT的诊断结果作为诊断标准,对WBC、CRP、SAA、PCT 4项指标的结果进行联合分析,计算单项检测和各种联合检测方法的灵敏度和特异度。结果:单项检测,CRP灵敏度最高,为77.91%,SAA、PCT特异度最高,均为95.00%,WBC灵敏度与特异度最低,分别为26.99%、90.00%,WBC的灵敏度与其余3项比较,差异均有统计学意义。双项联合检测,CRP+PCT的灵敏度最高,为87.11%;CRP+SAA、SAA+PCT特异度最高,均为90.00%;6种双项联合检测方法差异无统计学意义;三项联合检测,SAA+PCT+WBC灵敏度最高,为92.63%,CRP+SAA+WBC特异度最高,为85.00%。4种三项联合检测灵敏度和特异度间差异无统计学意义。CRP+SAA+PCT+WBC四项联合检测的灵敏度为94.48%,特异度为76.00%。结论:CRP、SAA、PCT、WBC四者联合应用的灵敏度最高,可应用于临床诊断社区获得性肺炎。

Objective: To investigate the value of white blood cell count(WBC), C-reactive protein(CRP), serum amyloid A(SAA) and procalcitonin(PCT) in the diagnosis and treatment of community-acquired pneumonia. Methods: A retrospective analysis of 163 patients with community-acquired pneumonia was performed. The clinical symptoms combined with imaging X-ray and CT diagnosis were used as the diagnostic criteria. The results of WBC, CRP, SAA and PCT were combined and calculated. Sensitivity and specificity of monitoring and various joint monitoring methods. Results: Single test, CRP sensitivity was the highest, 77.91%, SAA, PCT specificity was the highest, 95.00%, WBC sensitivity and specificity were the lowest, respectively 26.99%, 90.00%, WBC sensitivity compared with the other 3, the difference Both were statistically significant;the two-term combined test, CRP+PCT had the highest sensitivity, 87.11%, and CRP+SAA, SAA+PCT had the highest specificity, both were 90.00%. There was no statistical difference between the six dual-test methods. Significance;3 joint tests, SAA+PCT+WBC had the highest sensitivity, 92.63%, and CRP+SAA+WBC had the highest specificity, which was 85.00%. There was no significant difference in sensitivity and specificity between the four combinations. The sensitivity of the combined detection of CRP+SAA+PCT+WBC was 94.48% and the specificity was 76.00%. Conclusion: The combination of CRP, SAA, PCT and WBC has the highest sensitivity and can be used for clinical diagnosis of community acquired pneumonia.