血清C反应蛋白、降钙素原及乳酸在重症肺炎中的变化及临床意义

Changes and Clinical Significance of Serum C-Reactive Protein,Procalcitonin and Lactic Acid in Severe Pneumonia

目的:探究重症肺炎患者的血清C反应蛋白(CRP)、降钙素原(PCT)与乳酸水平变化,并分析其临床意义。方法:在2015年1月~2018年12月期间,于某院重症医学科选取62例重症肺炎患者进行观察,依据患者的预后情况将其分为存活组(40例)与死亡组(22例),检测并观察两组患者不同时间段的血清CRP、PCT、乳酸的水平,并分析其水平变化的临床意义。结果:两组患者入院时的血清CRP、PCT、乳酸水平无明显差异(P>0.05);治疗期间存活组患者的血清CRP、PCT、乳酸水平均逐渐降低,死亡组患者则呈逐渐升高的趋势,治疗第4d、治疗第7d、转出或死亡前存活组患者的血清CRP、PCT、乳酸水平均低于死亡组,差异具统计学意义(P<0.05)。结论:重症肺炎患者的血清CRP、PCT、乳酸水平随着病情进展逐渐增高,其水平的变化对于判断患者的病情严重程度、评价治疗效果、判断预后情况具有重要临床意义。

Objective:To investigate the changes of serum C-reactive protein(CRP),procalcitonin(PCT)and lactic acid levels in patients with severe pneumonia,and to analyze its clinical significance.Methods:From January 2015 to December 2018,62 patients with severe pneumonia were selected from the intensive care department of a hospital for observation.According to the prognosis of the patients,they were divided into the survival group(40 cases)and the death group(22 cases).Serum CRP,PCT and lactic acid levels in the two groups were detected and observed at different time periods,and the clinical significance of their changes was analyzed.Results:There was no significant difference between the two groups in serum CRP,PCT and lactic acid levels at the time of admission(P>0.05).The serum CRP,PCT and lactic acid levels of patients in the survival group gradually decreased during treatment,while those in the death group gradually increased.The serum CRP,PCT and lactic acid levels of the patients in the treatment group on the 4 th day,the 7 th day,the patients in the transfer group or the survival group before death were all lower than those in the death group,with statistically significant differences(P<0.05).Conclusion:Serum CRP,PCT and lactic acid levels in patients with severe pneumonia gradually increase with the progress of the disease,and the changes in their levels are of great clinical significance in determining the severity of the disease,evaluating the treatment effect and determining the prognosis of the patients.